Medullary carcinoma of the thyroid

Medullary carcinoma of the thyroid
Mark Wick
University of Virginia Health System
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Brief Description
This presentation illustrates a typical case of medullary thyroid carcinoma and considers pertinent differential diagnostic considerations.
Full Description
This presentation illustrates a typical case of medullary thyroid carcinoma and considers pertinent differential diagnostic considerations. Molecular diagnostics and prognosis pertaining to this tumor are also discussed.
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References
1: Liska J, Altanerova V, Galbavy S, Stvrtina S, Brtko J. Thyroid tumors: histological classification and genetic factors involved in the development of thyroid cancer. Endocr Regul 2005; 39: 73-83.
2: Brauckhoff M, Lorenz K, Ukkat J, Brauckhoff K, Gimm O, Dralle H. Medullary thyroid carcinoma. Scand J Surg 2004; 93: 249-260.
3: Baloch ZW, LiVolsi VA. Prognostic factors in well-differentiated follicular-derived carcinoma and medullary thyroid carcinoma. Thyroid 2001; 11: 637-645.
4: Pacini F, Elisei R, Romei C, Pinchera A. RET proto-oncogene mutations in thyroid carcinomas: clinical relevance. J Endocrinol Invest 2000; 23: 328-338.
5: Bussolati G, Papotti M, Pagani A. Diagnostic problems in medullary carcinoma of the thyroid. Pathol Res Pract 1995; 191: 332-344.
6: Uribe M, Fenoglio-Preiser CM, Grimes M, Feind C. Medullary carcinoma of the thyroid gland. Clinical, pathological, and immunohistochemical features with review of the literature. Am J Surg Pathol 1985; 9: 577-594.
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					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide11.JPG" id="image_11"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>11</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48295"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_12" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(12);">
			<span style="display:none;" id="span_12">|~|/files/powerpoints_images/node48271/Slide12.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide12.JPG" id="image_12"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>12</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48297"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_13" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(13);">
			<span style="display:none;" id="span_13">|~|/files/powerpoints_images/node48271/Slide13.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide13.JPG" id="image_13"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>13</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48299"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_14" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(14);">
			<span style="display:none;" id="span_14">|~|/files/powerpoints_images/node48271/Slide14.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide14.JPG" id="image_14"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>14</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48301"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_15" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(15);">
			<span style="display:none;" id="span_15">|~|/files/powerpoints_images/node48271/Slide15.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide15.JPG" id="image_15"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>15</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48303"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_16" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(16);">
			<span style="display:none;" id="span_16">|~|/files/powerpoints_images/node48271/Slide16.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide16.JPG" id="image_16"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>16</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48305"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_17" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(17);">
			<span style="display:none;" id="span_17">|~|/files/powerpoints_images/node48271/Slide17.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide17.JPG" id="image_17"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>17</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48307"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_18" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(18);">
			<span style="display:none;" id="span_18">|~|/files/powerpoints_images/node48271/Slide18.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide18.JPG" id="image_18"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>18</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48309"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_19" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(19);">
			<span style="display:none;" id="span_19">|~|/files/powerpoints_images/node48271/Slide19.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide19.JPG" id="image_19"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>19</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48311"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_20" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(20);">
			<span style="display:none;" id="span_20">|~|/files/powerpoints_images/node48271/Slide20.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide20.JPG" id="image_20"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>20</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48313"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_21" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(21);">
			<span style="display:none;" id="span_21">|~|/files/powerpoints_images/node48271/Slide21.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide21.JPG" id="image_21"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>21</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48315"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_22" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(22);">
			<span style="display:none;" id="span_22">|~|/files/powerpoints_images/node48271/Slide22.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide22.JPG" id="image_22"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>22</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48317"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_23" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(23);">
			<span style="display:none;" id="span_23">|~|/files/powerpoints_images/node48271/Slide23.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide23.JPG" id="image_23"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>23</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48319"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_24" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(24);">
			<span style="display:none;" id="span_24">|~|/files/powerpoints_images/node48271/Slide24.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide24.JPG" id="image_24"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>24</strong></td>
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													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48321"></div></td>
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		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_25" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(25);">
			<span style="display:none;" id="span_25">|~|/files/powerpoints_images/node48271/Slide25.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide25.JPG" id="image_25"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>25</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48323"></div></td>
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				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_26" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(26);">
			<span style="display:none;" id="span_26">|~|/files/powerpoints_images/node48271/Slide26.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide26.JPG" id="image_26"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>26</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48325"></div></td>
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												</tbody>
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					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_27" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(27);">
			<span style="display:none;" id="span_27">|~|/files/powerpoints_images/node48271/Slide27.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide27.JPG" id="image_27"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>27</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48327"></div></td>
													</tr>
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										</td>
									</tr>
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						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_28" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(28);">
			<span style="display:none;" id="span_28">|~|/files/powerpoints_images/node48271/Slide28.JPG|~|563|~|375|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="70" width="105" border="0" src="/files/powerpoints_images/node48271/Slide28.JPG" id="image_28"/>
							</div>
						</td>
						<td width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>28</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_48329"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
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				</tbody>
			</table>
		</div>
	</td>
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</tbody>
</table>
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Medullary carcinoma of the thyroid

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