Thyroid Cancer Flashcards
What is the key clinical feature that the majority of thyroid cancer’s present with
Thyroid lump
Name the two most common types of thyroid cancer
Papillary and follicular
Papillary and follicular are the two most common types of thyroid cancers.
Which one is the most common
Papillary (70%) of cases
What is the pathology of papillary thyroid cancer
Contains a mixture of papillary and colloidal filled follicles
What age bracket does papillary thyroid cancers typically present in
Tends to present 30-40 years of age
Where does papillary thyroid cancers typically metastase to?
Lymph node metastasis predominate
What is the prognosis of papillary thyroid cancers
Excellent prognosis
How does follicular thyroid cancer typically present with
Usually present as a solitary thyroid nodule
Name two risk factors for follicular thyroid cancer
Areas of low iodine
Women
What age group does follicular thyroid cancers typically present in
Tends to present 30-60 years of age
Name three risk factors for thyroid cancer
Radiation exposure (particularly in childhood)
Family history of thyroid cancer
Female sex
The majority of thyroid lump have a ___ disease
a) benign
b) cancerous
a) benign
The most common clinical feature of a thyroid cancer is a thyroid nodule or mass.
Name some of the other clinical features of thyroid cancer
Hoarseness/change in voice
Cervical lymphadenopathy
Stridor
What is a stridor
A harsh, high pitched sound, normally heard on inspiration
Indicative of upper airway obstruction
What does a stridor indicate
Indicative of upper airway obstruction
Why are features of hyperthyroidism or hypothyroidism not commonly seen in patients with thyroid malignancies?
Thyroid cancers rarely secrete thyroid hormones
When should you consider two week suspected cancer pathway referral for thyroid cancer
Anyone with an unexplained thyroid lump
What is the name of the set of investigations used to diagnose thyroid cancer
Triple Assessment
Triple Assessment refers to the set of investigations used to diagnose thyroid cancer
What are the three components of the triple assessment
Clinical examination with TFT
Ultrasound scan
Fine needle aspiration cytology
If we were unable to determine the type of thyroid cancer from fine needle aspiration cytology what is the next investigation?
Diagnostic hemithyroidectomy
What is the mainstay of thyroid cancer treatment
Surgical resection
What type of treatment may be included alongside surgical resection for thyroid cancer
Adjuvant management
Name the two types of thyroid surgical resection
Thyroidectomy – complete removal of the thyroid gland
Hemithyroidectomy – removal of half of the thyroid gland
Why might Hemithyroidectomy be a better option for smaller, unilocal thyroid cancers
There is an increased risk of hypoparathyroidism in thyroidectomy
What are two specific post op things that must be monitored after thyroid resection
Monitor serum calcium (+/- PTH)
Evaluate vocal cord function
Name three complications of thyroidectomy
Recurrent laryngeal nerve injury
Haematoma
Hypoparathyroidism
What happens if the recurrent laryngeal nerve is injured
Unilateral injury can result in vocal cord dysfunction
Bilateral injury as well as give vocal cord dysfunction it can threaten the airway and present with stridor
Haematoma is a potential complication of thyroidectomy.
Why is it so dangerous?
There is limited space for expansion and thus increasing pressure can threaten the airway.
What are the two forms of adjuvant therapy used in thyroid cancer management
Radioiodine remnant ablation
External beam radiotherapy
Remember these are only used with MDT input
