Thyroid cancer Flashcards
What are the two main cells types in the thyroid gland?
Follicular cells - secrete thyroxine
Parafollicular cells - secrete calcitonin
What are the signs of thyroid cancer?
Painless nodule Hard to move module Hoarse voice Sore throat Difficulty swallowing or breathing Swollen neck lymph nodes Diarrhoea and flushing
Which signs are seen if the tumour secretes other hormones?
Flushing (serotonin)
Diarrhoea
What is the most common type of thyroid cancer?
Papillary carcinoma 80%
Occurs from follicular cells
What is the second most common thyroid cancer?
Follicular carcinoma 15%
Also arises from follicular cells
What are causes of papillary carcinoma?
Exposure to ionising radiation
BRAF mutations
What are causes of follicular carcinomas?
Countries with low dietary iodine
How do papillary carcinomas spread?
Via the lymphatic system
What is the histology of papillary cancer?
Cells often have no nuclei
How does follicular carcinomas spread?
Via the blood vessels
Where does follicular carcinomas spread to?
Lungs
Liver
Bone
Brain
What is a cold nodule?
Most tumours are cold nodules - meaning they don’t function like the normal thyroid gland by secreting hormones.
What is a thyroid cancer with a very poor prognosis?
Anaplastic thyroid carcinoma
Rapid invasion and usually can’t be operated on
Which patient usually gets anaplastic thyroid carcinoma?
They are rare
Older patients
How can thyroid cancer be diagnosed?
Thyroid ultrasound
Radioiodine scan
Fine needle aspiration - gold standard
What are treatments for thyroid cancer?
Thyroidectomy - partial or full, followed by thyroid hormone replacement
Radioactive iodine
External radiotherapy
Chemotherapy
How are papillary and follicular carcinomas usually treated?
With surgery followed by radioactive iodine treatment
After radioactive iodine treatment how long can people not have kids for?
Females - 6 months
Males - 4 months
Which type of tumour is often part of the MEN syndrome?
Medullary carcinomas - they arise from parafollicular cells and often release other hormones (causing blushing and diarrhoea)
