Thyroid cancer Flashcards
Define:
Malignancy arising in the thyroid gland:
Types:
- Papillary (60%)
- Follicular (25%)
- Medullary (5%)
- Lymphoma (5%)
- Anaplastic (rare)
Aetiology:
Unknown
Risk factors:
Medullary thyroid cancer
MEN IIa and IIb
Lymphoma due to Hashimoto’s
Epidemiology:
Rare
More common in females
Papillary in 20-40 years
Follicular in 40-50 years
Symptoms:
Slow growing neck lump
Discomfort swallowing
Hoarse voice
Signs:
Palpable nodules and diffuse enlargement
Cervical lymphadenopathy
Usually euthyroid
Investigations:
Bloods:
- TFTs
- Bone profile
- Thyroid autoantibodies if Hashimoto’s/Graves’s suspected
Tumour Markers
• Thyroglobulin - papillary and follicular
• Calcitonin - medullary
CXR with thoracic inlet: tracheal goitres and metastases?
USS
Radionuclide scan: malignant lesions show as hypofunctioning (cold) whereas a hyperfunctioning hot lesion suggests adenoma
Fine-Needle Aspiration Cytology (FNA)
o Allows histological diagnosis
Excision Lymph Node Biopsy
o If there is cervical lymphadenopathy
CT/MRI - for staging