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30-09-2024 | Thyroid Cancer | Mini Review

Translating the desmoplastic microenvironment of medullary thyroid cancer into surgical practice

Authors: Andreas Machens, Henning Dralle

Published in: Endocrine

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Abstract

Purpose

The tumor microenvironment often induces a scarring process known as tumor fibrosis or desmoplasia, which plays an important role in the initiation, progression, and clinical outcome of many types of cancer. This report aimed to highlight recent progress made in the field of de-escalation surgery for sporadic medullary thyroid cancer (MTC), building a bridge from basic science to current and emerging medical practice.

Methods

This narrative review entails a holistic description and interpretation of the English-language literature on MTC desmoplasia.

Results

Absence of primary tumor desmoplasia on intraoperative frozen section and definitive histopathology goes hand in hand with absence of node metastases in up to one-third of patients with sporadic MTC. Patients with desmoplasia-negative MTC require no more than hemithyroidectomy for cure.

Conclusion

Thyroid desmoplasia is a powerful predictive tissue biomarker for the intraoperative management of patients with sporadic MTC, outpacing conventional tumor classification systems that depend on definitive histopathology.
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Metadata
Title
Translating the desmoplastic microenvironment of medullary thyroid cancer into surgical practice
Authors
Andreas Machens
Henning Dralle
Publication date
30-09-2024
Publisher
Springer US
Published in
Endocrine
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-024-04060-3

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