Endocrine Tumours

Question 1

What is the only type of benign thyroid tumour and is it non-functional?

Answer 1

Follicular adenoma, usually non-functional.

Question 2

In order of frequency, what are the 4 types of thyroid carcinoma?

Answer 2

Papillary, follicular, medullary, anaplastic.

Question 3

Describe a papillary thyroid carcinoma.

Answer 3

Cystic solitary nodule
May be calcified with psmammoma bodies
Mainly lymphatic spread
Cause local effects
Good survival rates

Question 4

Describe a follicular thyroid carcinoma.

Answer 4

High stage at presentation
Older patients than papillary
Usually single non-functional nodule
Mainly haematogenous spread
Invasive growth pattern
More solid with less follicular architecture. 
Difficult to distinguish from adenoma.

Question 5

Describe a medullary thyroid carcinoma.

Answer 5

Usually good prognosis
C-cell derived
Local effects
Has amyloid deposition in cells
Associated with MEN.

Question 6

Describe an anaplastic thyroid carcinoma.

Answer 6

Undifferentiated and aggressive

Rapid local growth causing death.

Question 7

What are the 3 types of pituitary adenoma in order of frequency?

Answer 7

Prolactinoma, GH secreting, ACTH secreting (usually microadenoma).

Question 8

How common are pituitary carcinomas?

Answer 8

Rare.

Question 9

What effect can pituitary tumours have on hormone production?

Answer 9

Can cause pan-hypopituitism.

Question 10

Where does a craniopharyngioma originate from?

Answer 10

Remnants of Rathke’s pouch.

Question 11

Describe a craniopharyngioma.

Answer 11

Slow growing cyst that may calcify
Cause headaches, visual disturbances and growth retardation in children
Excellent prognosis
Very rarely SCC may develop after radiotherapy

Question 12

Describe an adrenocortical adenoma.

Answer 12

Well circumscribed and encapsulated
Yellow/brown cut surface
Well differentiated with small nuclei and rare mitoses
Can be functional but more likely not

Question 13

Describe an adrenocortical carcinoma.

Answer 13

More likely to be functional (virilising tumours are usually malignant)
Rare
Low survival
Usually vascular metastasis
Forms a spectrum with adenoma

Question 14

What are the 2 main tumours of the adrenal medulla?

Answer 14

Phaeochromocytoma

Neuroblastoma

Question 15

Describe a neuroblastoma

Answer 15

Diagnosed in infancy
Primitive appearing cells
Earlier found the better the prognosis

Question 16

Describe a phaeochromocytoma

Answer 16

Derived from chromaffin cells
Cause secondary hypertension
Propensity for skeletal mets
Secrete catecholamines
Occurs in MEN2