Thyroid cancer

Question 1

What are types of thyroid cancer

Answer 1

Follicular, papillary, medullary, anaplastic, and lymphoma

Question 2

What are features of papillary thyroid carcinoma?

Answer 2

most common. It is usually well differentiated with a tendency towards multi-centricity and lymph node involvement.

Good prognosis

Question 3

What are features of follicular thyroid carcinoma?

Answer 3

It spreads through direct haematogenous invasion rather than lymph nodes. Early forms are indolent, whereas widely invasive forms are aggressive.

Question 4

what are features of anaplastic thyroid carcinoma?

Answer 4

Elderly women

An undifferentiated neoplasm with mitosis and vascular invasion. It usually presents with local encroachment into the recurrent laryngeal nerve and trachea, muscle, and/or oesophagus.

Question 5

What are features of medullary thyroid carcinoma?

Answer 5

, usually familial and associated with mutations in RET proto-oncogene). MEN2 syndrome

Secrete calcitonin

Question 6

What are risk factors for thyroid cancer?

Answer 6

• Head and neck irradiation
• Females
Being in 30s and 40s

Question 7

What are sx of thyroid cancer?

Answer 7

Firm, mobile mass

	• Hoarseness
	• Dysphagia 
	• Dyspnoea 
	• Tracheal deviation
Cervical lymphadenopathy

Question 8

What are favourable features in thyroid cancer?

Answer 8

• Female sex
	• Age <45 years
	• Size of nodule <4 cm
	• No extrathyroidal extension
	• Absence of metastatic disease
Low-grade histology.

Question 9

What Ix in suspected thyroid cancer?

Answer 9

TFTS: will be normal

US of neck

Fine needle aspiration of nodules and look at histology

Laryngoscopy: can show paralysed vocal cord.

Question 10

What are DDx for thyroid cancer?

Answer 10

Benign thyroid nodules

goitre

Question 11

What Rx for thyroid cancer?

Answer 11

Surgery
Radioiodine
TSH suppression

check yearly thyroglobulin levels