Thyroid CA

Question 1

What labs should be checked following thyroidectomy for papillary CA? What time range?

Answer 1

Thyroglobulin and anti-thyroglobulin Abs —> 6-8 weeks post-surgery.

Question 2

What TSH levels should be maintained following Differentiated Thyroid CA treatment?

Answer 2

High Risk –> TSH < 0.1
Low Risk –> TSH 0.1-0.5

Once 2+ years of disease free, can lessen the TSH to between 0.5-2.0

Question 3

What characteristics on US and FNA would lead to need for total thyroidectomy in papillary thyroid CA?

Answer 3

1) Extra-thyroidal extension
2) Nodule size > 4 cm
3) Distant Mets
4) Cervical Lymph Node Metastatic disease
5) Prior Radiation Exposure.

Question 4

What time frame does Radiation exposure play in Thyroid CA development?

Answer 4

Thyroid CA often develops 3-5 years following radiation expsosure.

Question 5

What therapy is recommended in Radioactive Iodine -Refractory metastatic Papillary Thyroid CA? What type of therapy is this?

Answer 5

Lenvatinib (Preferred) or Sorafenib

Tyrosine Kinase Inhibitors (TKIs)