Intraoperative Lymphonodal Staging of Clinically N0 Medullary Thyroid Microcarcinomas for Decision on Lateral Neck Dissection

Background: Serum calcitonin (Ct) levels in medullary thyroid carcinoma (MTC) usually correlate with tumor size and disease extent. Majority of surgeons recommend total thyroidectomy (TT) and central neck dissection (CND) in proven or suspected MTC, but the extent of lateral neck dissection (LND) remains controversial. The aim of this study was to analyze usefulness of sentinel lymph node (SLN) biopsy with methylene blue dye (MBD) for intraoperative lymph node (LN) staging and selection of clinically N0 (cN0) patients with micro-MTCs and serum Ct level below 1000pg/ml for one-time LND, along with TT and CND.