USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

Which type of medullary carcinoma has a better prognosis than the sporadic type?

1. Autosomal dominant MEN IIa/IIb

2. Sporadic

3. Primary

4. Familial

The correct answer is: Familial

The familial type of medullary carcinoma, often associated with hereditary syndromes like Multiple Endocrine Neoplasia type II (MEN II), tends to have a better prognosis compared to the sporadic type. This can be attributed to the fact that familial forms are often detected earlier due to genetic screening and regular surveillance of at-risk individuals. When identified early, these tumors can be treated before they metastasize, leading to improved outcomes. In contrast, sporadic cases are typically identified later in their progression, which can often result in a more advanced disease at the time of diagnosis. Furthermore, familial forms allow for specific genetic counseling and monitoring of family members, improving management strategies compared to cases that arise without a familial background.