Thyroid cancer

Question 1

Define thyroid cancer?

Answer 1

malignancy arising in thyroid gland

Question 2

what are the 5 types of thyroid cancer and state features of each?

Answer 2

Question 3

list the prevalence of each type of thyroid cancer from most prevalent to least?

Answer 3

Papillary

Follicular

Medullary

Lymphoma

Anaplastic

Question 4

what is a risk factor for papillary thyroid cancer?

Answer 4

childhood exposure to radiation

Question 5

what is a risk factor for medullary thyroid cancer?

Answer 5

may be familial

associated with MEN IIa or IIb

Question 6

what is a risk factor for lymphoma?

Answer 6

Hashimoto’s thyroiditis

Question 7

summarise the epidemiology of thyroid cancer?

Answer 7

RARE

More common in FEMALES

Papillary: 20-40 yrs

Follicular: 40-50 yrs

Anaplastic: more common in the ELDERLY

Question 8

what are the presenting symptoms of thyroid cancer?

Answer 8

Slow-growing neck lump

Discomfort swallowing

Hoarse voice- RED FLAG!!

Question 9

what are the signs of thyroid cancer on physical examination?

Answer 9

Palpable nodules or diffuse enlargement of thyroid gland

Cervical lymphadenopathy–> suspect malignancy

NOTE: the patient is usually euthyroid

Question 10

what are the investigations for thyroid cancer?

Answer 10

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