Thyroid Cancer

Question 1

Papillary carcinoma.
Most common malignant carcinoma: ?%.
More commonly presents at ?-?.
o Risk factor: previous neck ?.
Spreads ?, and metastasises to ? ?.
o Can go to ?/?, but this is rare.

Answer 1

70
40-50
irradiation
locally
local nodes
bone/lung

Question 2

Papillary Carcinoma
Cured by ? ?, including metastases.
o ? lymph node dissection if nodal involvement.
Ablative ? therapy as an adjunct.
Prognosis is ?.
o ? can be used as a tumour marker following ?.

Answer 2

surgical resection
neck
radioiodine
good
thyroglobulin
surgery

Question 3

Follicular carcinoma.
?% of cases of malignant carcinoma.
Metastasises via the ?, classically to ?.
Treat as per ? carcinoma.
Prognosis is ?.

Answer 3

20
blood
bone
papillary (resection, RI as adjunct)
good

Question 4

Medullary carcinoma.
?% of cases of malignant carcinoma.
Generally affects ? adults.
o Can affect children/ young adults as part of ? ? ? syndromes: ? ? ? Ila/ llb.
• Exclude ? prior to surgery in young patients.

Answer 4

5
older
Multiple endocrine neoplastic
MEN
Pheochromocytoma

Question 5

Medullary Carcinoma
Arise from the parafollicular / ‘C’ cells.
o They secrete ?, so plasma ? levels are raised.
- They are ? growing and cause ? pain, metastasing to ? ?, prognosis is ?.

Answer 5

calcitonin
calcitonin
slow
little
local nodes
poor

Question 6

Anaplastic carcinoma.
- % of cases of malignant carcinoma.
Occurs in ? populations.
Extremely ? aggressive, with ? and ? ? invasion.
o Complications of ?/? ? ? obstruction.
- ? thyroidectomy often not possible.
o External ? may give palliation.
Prognosis is ?.

Answer 6

5
elderly
locally
rapid
extensive
local
tracheal
superior vena cava
total
radiotherapy
poor

Question 7

? is a differential for the thyroid malignancy

Answer 7

lymphoma

Question 8

Presentation;
Most present as ? thyroid ? or ? ?.
There may be ?/?.
Thyroid dysfunction is ?.

Answer 8

aSx nodules
lymph nodes
hoarseness/dysphagia
rare

Question 9

Approach to a solitary thyroid nodule;

History I Examination.
? scans
? scans.
o 'Hot': suggests ?.
o 'Cold': may suggest ?.
Then ? ? ? ? or ? biopsy

Answer 9

uss
technetium
adenoma
malignancy
fnac
core