Medullary Thyroid Carcinoma Clinical Presentation

Updated: Jun 14, 2022
  • Author: Anastasios K Konstantakos, MD; Chief Editor: Neerav Goyal, MD, MPH, FACS  more...
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A specific constellation of symptoms of medullary thyroid carcinoma (MTC) is not usually noted; however, one or more of the following symptoms may be observed:

  • Patients may describe a lump at the base of the neck, which may interfere with or become more prominent during swallowing

  • Patients with locally advanced disease may present with hoarseness, dysphagia, and respiratory difficulty

  • Although uncommon, patients may present with various paraneoplastic syndromes, including Cushing or carcinoid syndrome

  • Diarrhea may occur from increased intestinal electrolyte secretion secondary to high plasma calcitonin levels

  • Distant metastases (eg, lung, liver, bone) may result in weight loss, lethargy, and bone pain


Physical Examination

Physical examination may demonstrate a dominant thyroid nodule at the base of the neck. Palpable cervical lymphadenopathy signifies disease that has progressed locally. Icterus, and rarely, bone tenderness may occur in patients with systemic metastases. 

Cutaneous lichen amyloidosis in MEN 2A patients manifests as multiple pruritic, hyperpigmented, lichenoid papules in the scapular area of the back. MEN2B patients may have a marfanoid habitus with mucosal neuromas.

Labile hypertension may be seen in those with an associated pheochromocytoma.