Differentiated Thyroid Cancer Flashcards
what types of thyroid cancer are differentiated (DTC)?
follicular
papillary
what substance do DTCs take up?
iodine
what do DTCs secrete that can be used as a tumour marker?
thyroglobulin
what drives DTCs?
TSH
which sex is more commonly affected by DTCs?
females
what is a risk factor for DTCs?
exposure to radiation
how do the majority of patients with DTCs present?
palpable nodules in the neck
what is the most common type of DTC?
papillary thyroid cancer
how does papillary thyroid cancer tend to spread?
lymphatics
where can papillary thyroid cancer spread via the haematogenous route?
lungs
bones
liver
brain
this is less common than lymphatic spread
what condition does papillary thyroid cancer have a small association with?
hashimoto’s thyroiditis
where is incidence of follicular thyroid cancer higher?
regions of relative iodine deficiency
how does follicular thyroid cancer tend to spread?
hematogenously
what is the investigation of choice for a DTC presenting as a thyroid lesion?
USS guided FNA
what is the investigation of choice for a DTC presenting as an enlarged neck node?
excision biopsy of the lymph node
what is the treatment of choice for a DTC?
surgery
what are the three most common surgical options for a DTC?
hemi thyroidectomy
sub total thyroidectomy
total thyroidectomy
what are the indications for hemi thyroidectomy in DTC?
papillary microcarcinoma
minimally invasive follicular carcinoma
AMES low risk group
what four things are assessed in the AMES risk assessment for DTC?
age
metastases
extent or primary tumour
size of primary tumour
what post-operative care is done following thyroid surgery for a DTC?
check calcium within 24 hours
replace calcium if <2
IV calcium if <1.8/symptomatic
discharge patient on T3 or T4
