Endocrine Neoplasms Flashcards by Danielle Dilday

What percentage of all cancers in 2020 were endocrine cancers?

3.1%

How well did you know this?

Not at all

Perfectly

What is the most common type of endocrine cancer?

Thyroid cancer

How well did you know this?

Not at all

Perfectly

What is the estimated incidence of new cases of thyroid carcinoma in the US for 2020?

52,890

How well did you know this?

Not at all

Perfectly

What is the median age of diagnosis for thyroid cancer?

45-50 years

How well did you know this?

Not at all

Perfectly

What is the 5-year relative survival rate for thyroid cancer?

98%

How well did you know this?

Not at all

Perfectly

What is the primary diagnostic tool for thyroid cancer?

Fine-needle aspiration

How well did you know this?

Not at all

Perfectly

Fill in the blank: The majority of thyroid nodules are ______.

benign

How well did you know this?

Not at all

Perfectly

What are the two main types of differentiated thyroid cancer?

Papillary carcinoma
Follicular carcinoma

How well did you know this?

Not at all

Perfectly

What is the classification of thyroid cancer according to the Bethesda system?

Nondiagnostic
Benign
Atypia of undetermined significance
Follicular neoplasm
Suspicious for malignancy
Malignant

How well did you know this?

Not at all

Perfectly

What is a key risk factor for thyroid cancer related to family history?

First degree relative with thyroid cancer

How well did you know this?

Not at all

Perfectly

What is the role of calcitonin in medullary thyroid cancer?

It is a tumor marker for MTC.

How well did you know this?

Not at all

Perfectly

What are the three types of Multiple Endocrine Neoplasia (MEN) syndromes?

MEN1
MEN2A
MEN2B

How well did you know this?

Not at all

Perfectly

Which MEN syndrome is characterized by medullary thyroid cancer, pheochromocytoma, and parathyroid tumors?

MEN2A

How well did you know this?

Not at all

Perfectly

What is the most common type of pituitary tumor in MEN1?

Prolactinoma

How well did you know this?

Not at all

Perfectly

What percentage of medullary thyroid cancer cases are familial?

25%

How well did you know this?

Not at all

Perfectly

What is the most important treatment variable influencing prognosis in thyroid cancer?

Adequate surgery

How well did you know this?

Not at all

Perfectly

True or False: Most patients with thyroid cancer have significant symptoms.

False

How well did you know this?

Not at all

Perfectly

What is the typical age range for the peak incidence of adrenal carcinoma?

Less than 5 years and between 40 and 50 years

How well did you know this?

Not at all

Perfectly

What is the typical survival rate for patients with adrenal carcinoma?

3-4 years

How well did you know this?

Not at all

Perfectly

What is the most common symptom of nonfunctioning adrenal tumors?

Abdominal mass

How well did you know this?

Not at all

Perfectly

Fill in the blank: Hypercortisolism, or ______ syndrome, is present in 50%-70% of hormone-secreting adrenal carcinoma.

Cushing

How well did you know this?

Not at all

Perfectly

What is the mutation associated with MEN1?

MEN1 gene at 11q13

How well did you know this?

Not at all

Perfectly

What is the primary treatment for children with thyroid cancer?

Thyroidectomy

How well did you know this?

Not at all

Perfectly

What is the role of TSH in the initial evaluation of a thyroid nodule?

To determine if a radioactive iodine scan is needed

How well did you know this?

Not at all

Perfectly

What is the most common type of tumor found in MEN1 affecting the pancreas?

Gastrinoma

What is the inheritance pattern of MEN syndromes?

Autosomal dominant

What is the prevalence of adrenal carcinoma in childhood cancers?

1.3%

What percentage of patients with functioning tumors may present symptoms of nonfunctioning tumors plus those due to excess hormone?

40%–60% ## Footnote This percentage indicates the complexity of diagnosing adrenal tumors due to overlapping symptoms.

What is hypercortisolism also known as?

Cushing syndrome ## Footnote Hypercortisolism is a condition characterized by excess cortisol, which can lead to various health issues.

In adrenal carcinoma, what percentage of cases might present with androgen excess in female patients?

20%–30% ## Footnote This condition can lead to symptoms of virilization in affected females.

What nodular characteristic is suggestive of adrenal carcinoma?

Large tumors >4–6 cm or increasing tumor growth over a 6-month period ## Footnote These growth patterns indicate a higher likelihood of malignancy.

What is the most common hormone produced by adrenal tumors?

Cortisol ## Footnote Approximately 50% of adrenal tumors produce hormones, with cortisol being the most prevalent.

What is the primary treatment for adrenal cancer?

Surgery ## Footnote Surgical intervention is the primary method for managing adrenal carcinoma.

What are the Weiss criteria used for?

Histologically distinguish adrenocortical cancer from adrenocortical adenoma ## Footnote These criteria help in the accurate diagnosis of adrenal tumors.

According to Weiss, how many findings are needed to diagnose adrenocortical carcinoma?

Three or more ## Footnote Specific findings include high nuclear grade, necrosis, and vascular invasion among others.

What is carcinoid syndrome most commonly associated with?

Small bowel NETs ## Footnote Carcinoid syndrome symptoms can include diarrhea, flushing, and bronchospasm.

What are the four D symptoms associated with glucagonoma?

Dermatosis, Diabetes, Deep Vein Thrombosis, and Depression ## Footnote These symptoms reflect the systemic effects of glucagon excess.

What is the prognosis for well-differentiated neuroendocrine tumors (NETs)?

Much better prognosis, with an overall five-year survival of approximately 67 percent ## Footnote This contrasts with poorly differentiated neuroendocrine carcinomas, which have a worse prognosis.

What is the primary risk factor for thyroid cancer?

Age, being female, and exposure to radiation ## Footnote These factors significantly increase the likelihood of developing thyroid cancer.

What is the common presentation of insulinoma?

Hypoglycemia that is insulin mediated ## Footnote This condition leads to episodes of low blood sugar due to excess insulin production.

What is a characteristic rash associated with glucagonoma?

Necrolytic Migratory Erythema ## Footnote This rash is a distinguishing feature of glucagonoma.

True or False: Biopsy is indicated if adrenal cancer is suspected.

False ## Footnote A biopsy is not recommended due to the risk of spreading the cancer.

What is the main treatment for gastrinomas?

Surgery if possible or anti-acid medications ## Footnote Gastrinomas are often associated with severe reflux and peptic ulcer disease.

What percentage of NCD deaths globally occurs in low- and middle-income countries?

More than three quarters ## Footnote This statistic highlights the disparity in health outcomes related to NCDs.

What are the main types of noncommunicable diseases (NCDs)?

* Cardiovascular diseases * Cancers * Chronic respiratory diseases * Diabetes ## Footnote These diseases account for a significant portion of global mortality.

What is the role of detection, screening, and treatment in managing NCDs?

Key components of the response to NCDs ## Footnote These strategies are essential for improving outcomes in affected populations.

T or F: most pts. w/ thyroid cancer will have abnormal thyroid functioning

false most have normal thyroid function tests

Iodine scans should be ordered if what is low?

TSH

T or F: hyperfunctioning nodules are rarely malignant

true

what sonographic features raise red-flags for a potential thyroid malignancy

hypoechoic thyroid irregular border microcalcifications

what is the biomarker used to detect reoccurrence of thyroid cancer

thryoglobulin

what gene is involved in 25% cases of medullary thyroid cancer?

RET proto-oncogene AKA: MEN syndromes

T or F: calcitonin concentration correlates to extent of disease as well as stage

true

what gene/protein is defective for MEN Type 1

MEN1: menin (tumor suppressor gene)

tumors of what endocrine structures are assoc. w/ MEN Type I?

pituitary parathyroid pancreas

w/ neoplasm is most commonly assoc. w/ MEN type I affecting the parathyroid?

hyperplasia or adenoma

MEN Type I malignant tumors are limited to what endocrine structure

pancreas

list the assoc. symptoms of MEN Type 1 hyperparathyroidism.

hypercalcemia kidney stones PUD hypopituitarism

what is MEN Type 2B characterized by

Medullary thyroid cancer pheochromocytoma

compare and contrast the differences b/t MEN 2A & 2B.

2b: not assoc. w/ hyperparathyroidism 2b: assoc. w/ ganglioneuromas & marfanoid habitus

why are biopsies a CI for adrenal carcinomas?

can spread the cancer also, cannot distinguish b/t benign and malignant tumors

what pharmaceutical agents are indicated for treatment of adrenal carcinoma

etoposide doxorubicin cisplatin mitotane

List the symptoms of carcinoid syndrome?

diarrhea facial flushing bronchospasm

T or F: most pts. w/ carcinoid syndrome have hepatic metastases

true

what bioactive substances are generally elevated in carcinoid syndrome

serotonin histamine prostaglandins tachykinins

chronic levels of bioactive substances produced from carcinoid tumors can lead to what long-term complications

valvular heart disease leading to right-sided heart failure mesenteric fibrosis

what foods can stimulate the flushing presentations for carcinoid syndrome

rich in amines: chocolate, avocados, nuts, alcohol

gastrinomas are most common in what region of the GI tract

duodenum

what are the symptoms of gastrinoma (AKA ZE syndrome)

severe reflux PUD

list the 4D symptoms of glucagonoma.

dermatosis diabetes DVT depression

Necrolytic migratory erythema is a characteristic rash of what neoplasm?

glucagonoma

list the symptoms of somatostatinoma

typically presents w/ diabetes cholelithiasis steatorrhea hypochlorhydria

what are the assoc. symptoms of Vipoma?

watery diarrhea hypokalemia hypochlorhydria