Thyroid Cancer Flashcards
what types of thyroid cancer are differentiated thyroid cancers (DTC’s)?
papillary
follicular
what do DTC’s tend to take up and what does this mean?
iodine
radioactive iodine can be used as an investigation
what do DTC’s tend to secrete and what does this mean?
thyroglobulin
can be used as a tumour markers
what drives DTC’s?
TSH
who is more commonly affected by DTC’s?
women
what is a strong risk factor for DTC’s?
exposure to radiation
what are two weak risk factors for DTC’s?
thyroid adenoma
chronic elevation of TSH
how do most thyroid tumours present?
a palpable nodule in the neck
what is the most common type of thyroid cancer?
papillary
how does papillary thyroid cancer tend to spread?
lymphatics
what does papillary thyroid cancer have a small association with?
hashimoto’s thyroiditis
what is the prognosis for papillary thyroid cancer?
very good
10 year mortality is <5%
what is the second most common type of thyroid cancer?
follicular thyroid cancer
where is incidence of follicular thyroid cancer slightly higher?
in regions of iodine deficiency
how does follicular thyroid cancer tend to spread?
hematogenously
how is thyroid cancer investigated if it presents as a thyroid lesion?
USS guided FNA
how is thyroid cancer investigated if it presents as an enlarged neck lymph node?
excision biopsy of the node
what is the treatment of choice for thyroid cancer?
surgery
what are the three most common surgical options for thyroid cancer?
hemi-thyroidectomy
sub total thyroidectomy
total thyroidectomy
what is another name for a hemi-thyroidectomy?
thyroid lobectomy with isthmusectomy
when is hemi-thyroidectomy done for thyroid cancer?
papillary microcarcinoma
minimally invasive follicular
low risk AMES group
what score is used to classify thyroid cancer patients as low or high risk?
AMES
what four things are considered in an AMES score?
age
metastases?
extent of primary tumour
size of primary tumour
what is the post op care after thyroid surgery?
check calcium
discharge with levothyroxine
when is a whole body iodine scan done?
3-6 months after thyroidectomy
what does TSH need to be for the best results in an iodine scan and how is this achieved?
greater than 20
rhTSH injections