Thyroid Cancer

Question 1

What is thyroid cancer?

Answer 1

It is defined as the proliferation of malignant cells in the thyroid gland

Question 2

What is the most common endocrine malignancy?

Answer 2

Thyroid cancer

Question 3

What are the four classifications of thyroid cancer?

Answer 3

Papillary Thyroid Cancer

Follicular Thyroid Cancer

Medullary Thyroid Cancer

Anaplastic Thyroid Cancer

Question 4

What is the most common classification of thyroid cancer?

Answer 4

Papillary thyroid cancer

Question 5

What is papillary thyroid cancer?

Answer 5

It is defined as the proliferation of a papillary thyroid cells

Question 6

Which patient group is most commonly affected by papillary thyroid cancer?

Answer 6

Young women < 40

Question 7

What metastasis is associated with papillary thyroid cancer?

Answer 7

Cervical lymph nodes

Question 8

What prognosis is associated with papillary thyroid cancer?

Answer 8

Excellent prognosis

Question 9

What is the second most common classification of thyroid cancer?

Answer 9

Follicular thyroid cancer

Question 10

What is follicular thyroid cancer?

Answer 10

It is defined as the proliferation of follicular thyroid cells

Question 11

Which patient group tend to be affected by follicular thyroid gland?

Answer 11

Middle-aged women

Question 12

What metastasis is associated with follicular thyroid cancer?

Answer 12

Local vasculature

Question 13

What is the third most common classification of thyroid cancer?

Answer 13

Medullary thyroid cancer

Question 14

What is medullary thyroid cancer?

Answer 14

It is defined as the proliferation of parafollicular thyroid cells

Question 15

What patient group tend to be affected by medullary thyroid cancer?

Answer 15

Those with a strong family history of thryoid disease

Question 16

What is a specific feature of medullary thyroid cancer? Explain

Answer 16

Increased serum calcitonin levels

Parafollicular thyroid cells secrete calcitonin

Question 17

What metastasis is associated with medullary thyroid cancer?

Answer 17

Lymphatic spread

Haematogenous spread

Question 18

What prognosis is associated with medullary thyroid cancer?

Answer 18

Poor prognosis

Question 19

What condition is medullary thyroid cancer associated with? What does this result in?

Answer 19

MEN-2 syndrome

This means that medullary thyroid cancer present with additional clincial features associated with parathyroid tumours and phaechromocytomas

Question 20

What is MEN-2 syndrome?

Answer 20

It is a genetic condition associated with three primary endocrine tumours; medullary thyroid cancer, parathyroid cancer and phaeochromocytoma

Question 21

What is the fourth most common classification of thyroid cancer?

Answer 21

Anaplastic thyroid cancer

Question 22

What is anaplastic thyroid cancer?

Answer 22

It is defined as the proliferation of undifferentiated thyroid cells

Question 23

Which patient group tends to be affected by anaplastic thyroid cancer?

Answer 23

Elderly women > 60

Question 24

What metastasis is associated with anaplastic thyroid cancer?

Answer 24

Local & Aggressive

Question 25

What prognosis is associated with anaplastic thyroid cancer?

Answer 25

Worst prognosis

Question 26

What are the eight risk factors associated with thyroid cancer?

Answer 26

Young Age < 30 Years Old Older Age > 60 Years Old Female Gender Family History Obesity Thyroiditis Acromegaly Head & Neck Radiation

Question 27

Which two genetic conditions are associated with thyroid cancer?

Answer 27

Familial adenomatous polyposis (FAP) Cowden’s syndrome

Question 28

What five clincial features are associated with thyroid cancer?

Answer 28

Painless Neck Lump Cervical Lymphadenopathy Voice Hoarseness Dysphagia Weight Loss

Question 29

What are the two characteristic features of neck lumps associated with thyroid cancer?

Answer 29

They move on swallowing They don't move on tongue protrusion

Question 30

What are the three investigations used to diagnose thyroid cancer?

Answer 30

Blood Tests Ultrasound Scan Thyroid Biopsy

Question 31

What four blood test results indicate thyroid cancer?

Answer 31

Normal T3 Levels Normal T4 Levels Normal TSH Levels Increased Calcitonin Levels

Question 32

What thyroid cancer is Hashimoto's thyroiditis associated with?

Answer 32

Thyroid lymphoma

Question 33

When are ultrasound scans used to investigate thyroid cancer?

Answer 33

They are recommended following normal thyroid function test results

Question 34

How are ultrasound scans used to investigate thyroid cancer?

Answer 34

They are used to confirm a diagnosis of thyroid cancer

Question 35

What is the gold standard investigation used to diagnose thyroid cancer?

Answer 35

Thyroid Biopsy

Question 36

How are thyroid biopsies used to investigate thyroid cancer?

Answer 36

They are used to used to confirm a diagnosis of thyroid cancer In addition, it can be used to identify the classification of thyroid cancer

Question 37

What is the radiotherapy management option of thyroid cancer?

Answer 37

Radioiodine Therapy

Question 38

When is radioiodine therapy used to manage thyroid cancer?

Answer 38

It is the second line management option used to treat papillary, follicular and medullary thyroid cancer It is conducted following total thyroidectomy, in order to ensure removal of residual cells

Question 39

What is radioiodine therapy?

Answer 39

It It involves consumption of radioactive iodine, which is then absorbed by the thyroid gland This absorption results in radiation emission, and therefore destruction of thyroid cells

Question 40

What is the surgical management option of thryoid cancer?

Answer 40

Total Thyroidectomy

Question 41

When is total thyroidectomy used to manage thyroid cancer?

Answer 41

It is the first line management option used to treat papillary, follicular and medullary thyroid cancer

Question 42

What is total thyroidectomy?

Answer 42

It involves removal of the entire thyroid gland

Question 43

What pharmacological management option is recommended following total thyroidectomy?

Answer 43

Lifelong levothyroxine

Question 44

How do we monitor thyroid cancer, following successful treatment?

Answer 44

Annual thyroglobulin

Question 45

When is palliative management used to manage thyroid cancer?

Answer 45

It is used to treat anaplastic thyroid cancer