Thyroid cancer

Question 1

Define thyroid cancer & types (4)

Answer 1

Malignancy arising in the thyroid gland

Types:
Papillary
Follicular
Medullary
Anaplastic

Question 2

Aetiology of thyroid cancer

Answer 2

UNKNOWN

Question 3

Risk factors for thyroid cancer

3

Answer 3

Childhood exposure to radiation
Medullary thyroid cancers may be familial & associated w/ MEN IIa or IIb
Lymphoma associated w/ Hashimoto’s thyroiditis

Question 4

Epidemiology of thyroid cancer

prevalence, gender, age x3

Answer 4

RARE
More common in females 
Papillary: 20-40yrs
Follicular: 40-50yrs
Anaplastic: more common in ELDERLY

Question 5

Presenting symptoms of thyroid cancer

3

Answer 5

Slow growing neck lump
Discomfort swallowing
Hoarse voice

Question 6

Signs of thyroid cancer on physical examination

3

Answer 6

Palpable nodules or diffuse enlargement of thyroid gland
Cervical lymphadenopathy —> suspect malignancy
Patient is usually euthyroid

Question 7

Investigations for thyroid cancer

5

Answer 7

Bloods

Fine needle aspiration cytology (FNA)

Excision lymph node biopsy

Isotope scan

CT/MRI

Question 8

Investigations for thyroid cancer - bloods

3

Answer 8

TFTs
Bone profile 
Tumour markers
thyroglobulin: papillary & follicular
calcitonin: medullary

Question 9

Investigations for thyroid cancer - FNA

Answer 9

Allows histological diagnosis

Question 10

Investigations for thyroid cancer - excision node biopsy

Answer 10

If there is cervical lymphadenopathy

Question 11

Investigations for thyroid cancer - isotope scan

Answer 11

If cause of thyroid lump is unclear

Question 12

Investigations for thyroid cancer - CT/MRI

Answer 12

For staging