L4: Thyroid Neoplasm

Question 1

Types of Thyroid Neoplasm

Answer 1

• Benign
• Malignant

Question 2

Benign Thyroid Neoplasm

Answer 2

Folliclar adenoma

Question 3

Types of Malignant Thyroid Neoplasm

Answer 3

Dunhill classification

• Primary
• Secondary

Question 4

Types of Primary Thyroid Cancer

Answer 4

Question 5

Secondary Thyroid Cancer

Answer 5

Rare

• Metastatic: from colon, kidney, melanoma, breast
• Direct invasion.

Question 6

CP of Follicular adenoma

Answer 6

Presents as solitary nodules.

Question 7

DDx of Follicular adenoma

Answer 7

Question 8

Types of Follicular adenoma

Answer 8

Question 9

TTT of Follicular adenoma

Answer 9

Surgical treatment

• By excision (preferably a hemithyroidectomy = a lobectomy of the side of the adenoma + isthmectomy.).

Question 10

Follow up for Follicular adenoma

Answer 10

Prolonged follow up is unnecessary. Why?
- As the remaining thyroid tissue is normal.

Question 11

Incidence of Malignant Thyroid Tumors

Answer 11

Common in females (3:1)

Question 12

etiology of Malignant Thyroid Tumors

Answer 12

Question 13

Inheritance of Cowden Syndrome

Answer 13

Autosomal dominant

Question 14

Etiology of Cowden Syndrome

Answer 14

Germ cell mutation of PTEN tumor suppressor gene.

Question 15

CP of Cowden Syndrome

Answer 15

Question 16

Origin of Differentiated Thyroid carcinoma (DTC)

Answer 16

Derived from follicular cells

Question 17

Types of Differentiated Thyroid carcinoma (DTC)

Answer 17

• Papillary.
• Follicular carcinomas.
• Papillofollicular.
• Hurthle cell carcinomas.

Question 18

Incidence of Differentiated Thyroid carcinoma (DTC)

Answer 18

90% of thyroid malignancies

Question 19

CP of Differentiated Thyroid carcinoma (DTC)

Answer 19

Incidence of thyrotoxicosis in DTCs is 2%.

Question 20

Spread of Differentiated Thyroid carcinoma (DTC)

Answer 20

• Papillary spreads through nodes
• follicular through blood

Question 21

Pathology (Characters that histologically indicate malignancy in thyroid neoplasm) …….

Answer 21

Question 22

Def of Psammoma bodies

Answer 22

Small areas of perivascular calcification in necrosed hyalinized cells.

Question 23

X-Ray of Psammoma bodies

Answer 23

Question 24

Incidence of Papillary Carcinoma

Question 25

Age of **Papillary Carcinoma**

Question 26

sex **Papillary Carcinoma**

Question 27

Etiology **Papillary Carcinoma**

Question 28

Classification **Papillary Carcinoma**

Question 29

NE **Papillary Carcinoma**

Question 30

Spread **Papillary Carcinoma**

Question 31

ME **Papillary Carcinoma**

Question 32

Prognosis **Papillary Carcinoma**

Question 33

Incidence **Follicular Carcinoma**

Question 34

Age **Follicular Carcinoma**

Question 35

Sex **Follicular Carcinoma**

Question 36

Etiology **Follicular Carcinoma**

Question 37

Classification **Follicular Carcinoma**

Question 38

ME **Follicular Carcinoma**

Question 39

what is Hurthle Cell tumor?

Answer 39

Are variant of follicular neoplasm in which oxiphil cell predominate

Question 40

Spread **Follicular Carcinoma**

Question 41

Prognosis **Follicular Carcinoma**

Question 42

Incidence **Anaplastic Carcinoma**

Question 43

Age **Anaplastic Carcinoma**

Question 44

sex **Anaplastic Carcinoma**

Question 45

NE **Anaplastic Carcinoma**

Question 46

ME **Anaplastic Carcinoma**

Question 47

Spread **Anaplastic Carcinoma**

Question 48

Prognosis **Anaplastic Carcinoma**

Question 49

Incidence **Medullary carcinoma**

Answer 49

uncommon (5%) type of thyroid malignancy.

Question 50

Types of **Medullary carcinoma**

Answer 50

- Sporadic - MCT with MEN II Syndrome (Most Aggressive) - Familial Non-MEN MCT (Least Malignant)

Question 51

Incidence of Sporadic **Medullary carcinoma**

Question 52

NE of Sporadic **Medullary carcinoma**

Question 53

Site of Sporadic **Medullary carcinoma**

Question 54

MCT WITH MEN I| SYNDROME

Answer 54

(MORE AGGRESSIVE)

Question 55

Incidence **MCT With MEN II Syndrome**

Question 56

NE **MCT With MEN II Syndrome**

Question 57

Aggressiveness **MCT With MEN II Syndrome**

Question 58

**Familial Non-MEN MCT**

Answer 58

LEAST MALIGNANT

Question 59

Mutation **Familial Non-MEN MCT**

Question 59

NE **Familial Non-MEN MCT**

Question 60

NE of **MTC**

Question 61

ME of **MTC**

Question 62

Spread of **MTC**

Answer 62

Mainly to lymph nodes (60%).

Question 63

Is **MTC** TSH-Dependent?

Answer 63

Not TSH dependent & does not take up radioactive iodine.

Question 64

CP of Thyroid Carcinoma

Answer 64

Question 65

Hx **CARCINOMA ON PREEXISTING MULTINODULAR GOITER** **(BILATERAL CARCINOMA)**

Answer 65

Question 66

- Ex **CARCINOMA ON PREEXISTING MULTINODULAR GOITER** **(BILATERAL CARCINOMA)**

Answer 66

Question 67

- Hx **SYMPTOMLESS STN IN THE HEALTHY GLAND OF A YOUNG MALE CHILD** **(CARCINOMA DE NOVO - UNILATERAL)**

Answer 67

Question 68

- Investigations **SYMPTOMLESS STN IN THE HEALTHY GLAND OF A YOUNG MALE CHILD** **(CARCINOMA DE NOVO - UNILATERAL)**

Answer 68

Histologically such minor is papillary carcinoma.

Question 69

- Hx **LUMP IN THE NECK WITH AN OCCULT PRIMARY TUMORS ON THE THYROID** **(OCCULT CARCINOMA - UNILATERAL)**

Answer 69

Question 70

- Ex **LUMP IN THE NECK WITH AN OCCULT PRIMARY TUMORS ON THE THYROID** **(OCCULT CARCINOMA - UNILATERAL)**

Answer 70

Question 71

- Investigation **LUMP IN THE NECK WITH AN OCCULT PRIMARY TUMORS ON THE THYROID** **(OCCULT CARCINOMA - UNILATERAL)**

Answer 71

biopsy of the LNs Shows thyroid tissue with papillary Carcinoma.

Question 72

- Hx **RAPIDLY INCREASING SWELLING OF THE THYROID WITH HOARSENESS OF VOICE, DYSPNEA** **(DIFFUSE OR BILATERAL CARCINOMA DE NOVO)**

Answer 72

Question 73

- Ex **RAPIDLY INCREASING SWELLING OF THE THYROID WITH HOARSENESS OF VOICE, DYSPNEA** **(DIFFUSE OR BILATERAL CARCINOMA DE NOVO)**

Answer 73

Question 74

- Investigations **RAPIDLY INCREASING SWELLING OF THE THYROID WITH HOARSENESS OF VOICE, DYSPNEA** **(DIFFUSE OR BILATERAL CARCINOMA DE NOVO)**

Answer 74

Histopathologically, It shows anaplastic carcinoma of the thyroid.

Question 75

MALIGNANT CHANGE ON A PREEXISTING STN

Answer 75