FAMILIAL NONMEDULLARY THYROID-CANCER - AN EMERGING ENTITY THAT WARRANTS AGGRESSIVE TREATMENT

Objective: To determine whether familial nonmedullary thyroid carcinom a behaves like sporadic carcinoma of follicular cell origin. Design: R etrospective review. Setting: University medical center. Patients: Fou rteen patients were treated for familial nonmedullary thyroid carcinom a between 1980 and 1994. Thirteen families were identified, with 30 af fected individuals. Interventions: Patients were treated with coral or completion total thyroidectomy. Thirteen additional operations were p erformed to control recurrent disease. Main Outcome Measures: Stage, r ecurrence, and survival. Patients were followed up for a mean of 6.5 y ears. Results: In our 14 patients, 13 tumors were multifocal, and six of these were bilateral. The incidences of lymph node metastasis and l ocal invasion were both 57% (n=8). Seven patients (50%) had recurrence s during follow-up. Conclusions: Familial nonmedullary thyroid carcino ma has a high incidence of multifocality and invasion and a high rate of local recurrence. Aggressive initial treatment and careful follow-u p seem to be indicated.