Thyroid Cancer

Question 1

Define

Answer 1

DEFINITION: malignancy arising in the thyroid gland. Types include:

Papillary

Follicular

Medullary

Anaplastic

Question 2

Causes

Answer 2

UNKNOWN

Risk Factors

• Childhood exposure to radiation
• Medullary thyroid cancers may be familial and are associated with MEN IIa or IIb
• Lymphoma is associated with Hashimoto’s thyroiditis

Question 3

Epidemiology

Answer 3

RARE

More common in FEMALES

Papillary: 20-40 yrs

Follicular: 40-50 yrs

Anaplastic: more common in the ELDERLY

Question 4

Symptoms

Answer 4

Slow-growing neck lump

Discomfort swallowing

Hoarse voice

Question 5

Signs

Answer 5

Palpable nodules or diffuse enlargement of thyroid gland

Cervical lymphadenopathy –> suspect malignancy

NOTE: the patient is usually euthyroid

Question 6

Investigations

Answer 6

Bloods

• TFTs
• Bone profile
• Tumour Markers
  
  • Thyroglobulin - papillary and follicular
  • Calcitonin - medullary

Fine-Needle Aspiration Cytology (FNA)

• Allows histological diagnosis

Excision Lymph Node Biopsy

• If there is cervical lymphadenopathy

Isotope Scan

• If the cause of the thyroid lump is unclear

CT/MRI - for staging