Surveillance: Annual measurement of serum calcitonin concentration to detect residual or recurrent MTC after thyroidectomy, even if thyroidectomy was performed prior to biochemical evidence of disease.
Prevention of secondary complications: Prior to any surgery in an individual with MEN2A or MEN2B, the presence of a functioning pheochromocytoma should be excluded by appropriate biochemical screening. Prevention of primary manifestations: Prophylactic thyroidectomy for individuals with an identified germline RET pathogenic variant. Primary hyperparathyroidism is treated with surgery to remove one or more parathyroid glands, or more rarely, with medications to reduce parathyroid hormone secretion. Pheochromocytomas detected by biochemical testing and radionuclide imaging are removed by adrenalectomy. Kinase inhibitors may be used in metastatic MTC. External beam radiation therapy or intensity-modulated radiation therapy can be considered for advanced locoregional disease.
Treatment of manifestations: Treatment for MTC is surgical removal of the thyroid gland and lymph node dissection.
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