Thyroid Cancer

Question 1

Types of Thyroid cancer (FLAPM)

Answer 1

Papillary (MC - 70%)
Follicular (25%)
Anaplastic - WORST PROGNOSIS
Lymphoma
Medullary cell

Question 2

Epidemiology

Answer 2

Females > Males

Question 3

Risk factors

Answer 3

Radiation
Female
Family history of thyroid cancer

Question 4

Aetiology

Answer 4

Gene alteration
Proto-oncogene = normal genes
Tumour suppressor gene (TSG)

Question 5

Signs and symptoms

Answer 5

THYROID NODULES esp. Hard + Irregular
May have local compression of recurrent laryngeal nerve - HOARSE VOICE
Tracheal deviation
Neck enlargement
Dyspnoea

Question 6

Mets sites

Answer 6

LUNG (50%)
BONE (30%)
LIVER (10%)
BRAIN (5%)

Question 7

Diagnosis

Answer 7

FIRST LINE: Fine needles biopsy
TFT’s - to check if hyperthyroid or hypothyroid (TSH,T3/T4)
USS of neck
Laryngoscopy

Question 8

Treatment

Answer 8

Papillary + follicular + medullary = thyroidectomy + radioactive iodine ablation
Anaplastic = doesn’t respond to radioactive iodine = palliative care mostly
Lymphoma = radiation + chemotherapy (CHOP_
- Cyclophosphamide
- Doxorubicin Hydrocortisone
- Vincristine Sulphate (Oncovin)
- Prednisolone