thyroid cancer Flashcards
thyroid cancer tumor markers? what are differentiated thyroid cancer?
thyroglobulin: produced by thyroid gland as precursor of thyroid hormones. it’s done after total thyroidectomy and if +ve it indicates recurrence of cancer.
calcitonin: it’s produced by parafollicular cells which is the origin for medullary thyroid cancer. calcitonin can cause diarrhea and facial flushing. associated with MEN2
differentiated thyroid cancer: papillary(most common), follicular, hurthle cell
when to do lobectomy vs total thyroidectomy with/without lymphadenectomy
if nodule is <4cm
-no lymph node metastas
-extrathyroid extension
DO LOBECTOMY
if nodule <4cm
-lymph node metastas
-extrathyroid extension
DO TOTAL THYROIDECTOMY with lymphadenectomy
if nodule has aggressive features like
*>4cm
*lymph node metastas
*extrathyroid extension
DO TOTAL THYROIDECTOMY
-hx of neck radiation, family hx of thyroid cancer
what to do after total thyroidectomy?
iodine radiation (for well differentiated cancers), thyroid hormone supplementation
thyroid cancer pathology?
papillary cancer: psamomma bodies, orphan annie eye nuclei (papi and momma adopted orphan annie)
follicular cancer: uniform follicles
medullary cancer: ovoid cells from C cells without follicular development. amyloid in stroma (composed of C cells produces Calcitonin, amyloid aCCumulation & stains with Congo red)
anaplastic: undifferentiated giant cells
complications of thyroidectomy?
-hypocalcemia (accidental removal of parathyroid) -> perioral numbness, paresthesia of hands and feet, chvostek sign (face twitching when tapping facial nerve), trousseau sign (carpopedal spasm when inflating BP cuff)
hematoma (obstructive symptoms)
tracheal/esophageal injury
unilateral injury to recurrent laryngeal nerve: hoarseness
bilateral injury to recurrent laryngeal: dyspnea
external branch of superior layngeal: loss of high pitch sounds
internal branch of superior laryngeal: loss of larynx sensation above vocal cords
