Thyroid cancer 1 Flashcards Preview

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Flashcards in Thyroid cancer 1 Deck (19):
1

What are the different histological types of thyroid cancer ?

  • Papillary - 76%
  • Follciular - 17%
  • Medullary - 3%
  • Anaplastic - 2%

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

3

What are the 2 main types of DTC?

Papillary and follicular 

4

What DTC's take up and secrete ?

Take up iodine and secrete thyroglobulin 

5

What has a strong association with predisposing people to developing thyroid cancers ?

Exposure to radiation 

6

What do patients with thyroid cancer tend to present with on examination?

Majority with palpable nodules 

7

What is the most common class of thyroid cancer ?

Papillary

8

Describe the typical route of spread for papillary cancers 

Tend to spread via lymphatics - 40% of patients will have lymph node metastases at presentation 

9

What condition is papillary thyroid cancers associated with ?

Hashimotos thyroiditis

10

How do follicular thyroid cancers tend to spread ?

Haematogenously 

11

In what areas is there a higher incidence of follicular thyroid cancers ?

Areas of relative iodine deficiency 

12

The prognosis of papillary and follicular thyroid cancers is relatively similar what is it ?

Very good - 10 year mortality < 5%

13

What investigation is done to diagnose a DTC ?

US guided FNA of the lesion

14

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 

15

What is the treatment of thyroid cancers ?

Surgery 

options are:

  • Sub-total or total thyroidectomy
  • Lobectomy with isthmectomy 

16

What is used to classify patients as high or low risk patients post-op?

AMES 

  • Age 
  • Metastases
  • Extent of primary tumour 
  • Size of primary tumour 

17

Give some examples of low risk AMES patinets 

  • Young patients no evidence of metastases 
  • Older patients no metastases, or minimally invasive lesion
  • Tumour < 5cm

18

Give some examples of high risk AMES patients 

  • All patients with distant metastases 
  • Extrathyroidal disease in patients with papillary cancer 
  • Tumour > 5cm in older patients

 

19

When would you do a thyroid lobectomy with isthectomy ?

  • Papillary microcarcinoma (<1cm)
  • Minimally invasive follicular carcinoma with capsular invasion only