Thyroid cancer 1 Flashcards
What are the different histological types of thyroid cancer ?
- Papillary - 76%
- Follciular - 17%
- Medullary - 3%
- Anaplastic - 2%
What is a differentiated thyroid cancer ?
- This is when the cells in these cancers looks a lot like normal thyroid tissue, they are well differentiated and have a good prognosis.
- These cancers develop from thyroid follicular cells
What are the 2 main types of DTC?
Papillary and follicular
What DTC’s take up and secrete ?
Take up iodine and secrete thyroglobulin
What has a strong association with predisposing people to developing thyroid cancers ?
Exposure to radiation
What do patients with thyroid cancer tend to present with on examination?
Majority with palpable nodules
What is the most common class of thyroid cancer ?
Papillary
Describe the typical route of spread for papillary cancers
Tend to spread via lymphatics - 40% of patients will have lymph node metastases at presentation
What condition is papillary thyroid cancers associated with ?
Hashimotos thyroiditis
How do follicular thyroid cancers tend to spread ?
Haematogenously
In what areas is there a higher incidence of follicular thyroid cancers ?
Areas of relative iodine deficiency
The prognosis of papillary and follicular thyroid cancers is relatively similar what is it ?
Very good - 10 year mortality < 5%
What investigation is done to diagnose a DTC ?
US guided FNA of the lesion
What are some of the clinical signs of malignancy in thyroid cancer ?
- New nodule < 20 or > 50
- Male
- Nodule increasing in size
- Lesion > 4 cm
- History of head and neck irritation
- Vocal cord palsy
What is the treatment of thyroid cancers ?
Surgery
options are:
- Sub-total or total thyroidectomy
- Lobectomy with isthmectomy
