Clinicopathological Characteristics and Prognostic Factors of Medullary Thyroid Carcinoma: A Retrospective Study from a Tertiary Care Center

Open Access

Abstract

Introduction: MTC spreads early, often before symptoms show up, and mostly doesn't respond to standard iodine-based treatments. It starts in the C cells near the thyroid's follicles. Plus, plus, it makes it a rare Deadly form of cancer despite being only a small part of thyroid tumors. This research looked at patient outcomes in a major hospital, focusing on how disease patterns and biological traits affect survival chances. That said, some features like tumor size or lymph node involvement end up shaping prognosis really. Methods & Materials: The present retrospective and observational study was conducted at the Department of ENT, Ad-din women's Medical College, Dhaka, Bangladesh, during January 2025 to December 2025 among 52 patients diagnosed with MTC and treated through surgery. The clinical outcomes were studied according to the size of the tumors, age, time for surgery, and history of the patients. Data analysis was done by SPSS v.26. Result: Among 52 patients with medullary thyroid carcinoma, the majority were aged 40–49 years (26.9%) with slight male predominance (53.8%). All patients presented with thyroid swelling (100%), while cervical lymphadenopathy was seen in 57.7%. Tumors were most commonly 2–4 cm in size (50%), with extrathyroidal extension in 38.5% and lymphovascular invasion in 34.6%; amyloid deposition was noted in 84.6%. Lymph node metastasis occurred in 61.5% and distant metastasis in 19.2% (liver 9.6%, lung 5.8%, bone 3.8%). Advanced-stage disease (Stage III–IV) was present in 61.6%. Elevated calcitonin was observed in 76.9%, with recurrence in 26.9% and mortality in 15.4%. Conclusion: Lymph node metastasis was common at first diagnosis, often linked to bigger tumors spreading beyond the thyroid. Many cases showed extrathyroidal growth and were diagnosed in midlife, slightly more in men. The cancer usually appeared as a swollen thyroid, with stage progression typical among those presenting late.