Stage IV medullary thyroid cancer

Stage IV is divided into stages IVA, IVB, and IVC. In stage IVA, the tumor is any size and (1) cancer has spread from the thyroid to soft tissue under the skin, the esophagus, the trachea, the larynx, or the recurrent laryngeal nerve (a nerve that goes to the larynx); cancer may have spread to lymph nodes on one or both sides of the neck; or (2) cancer may have spread from the thyroid to nearby muscles in the neck; cancer has spread to lymph nodes on one or both sides of the neck. In stage IVB, the tumor is any size and cancer has spread to tissue in front of the spine or to the spine or has surrounded the carotid artery or the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes. In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs or liver. Cancer may have spread to lymph nodes.

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