Thyroid Disorders: Thyroid Cancers

Question 1

Describe the main types of thyroid cancer: name/age it occurs in/spread/prognosis

Answer 1

1. ) Papillary (70%): young people/local/good
2. ) Follicular (20%): middle age/lung or bone/good
3. ) Medullary cell (5%): familial/local + metastases/poor
4. ) Lymphoma (2%): variable/poor
5. ) Anaplastic (>5%): aggressive/local/v poor

Question 2

Describe the main symptoms of thyroid cancer

Answer 2

1. ) Thyroid nodules: increase in size/hardness + irregularity
2. ) Dysphagia
3. ) Hoarseness of voice: tumour is pressing on the recurrent laryngeal nerve

Question 3

Describe the main signs of thyroid cancer

Answer 3

1. ) Lymph node metastases
2. ) Lung/bone metastases (rare)
3. ) Thyroid nodule
4. ) Hard + irregular nodule
5. ) Enlarge lymph nodes

Question 4

Describe the differential diagnosis for thyroid cancer

Answer 4

Goitre

Question 5

Describe the main investigations for thyroid cancer

Answer 5

1. ) Fine needle aspiration cytology biopsy: best for distinguishing between benign and malignant nodules
2. ) Thyroid ultrasound
3. ) TFTs

Question 6

Describe the main treatments for thyroid cancer

Answer 6

1. ) Follicular + papillary cancers: do a total thyroidectomy and ablative radioiodine is given
2. ) Anaplastic and lymphoma: external radiotherapy BUT majority of treatment is palliative