thyroid cancer and nodules Flashcards
what % of solitary thyroid nodules are benign
95%
name some benign thyroid tumours (4)
cyst, colloid nodule, follicular adenoma, hyperplastic nodule
what are benign thyroid tumours encapsulated by and are they functional/ non functional
collagen - nonfunctional
what malignant thyroid nodules are there
papillary thyroid carcinoma, follicular carcinoma, medullary carcinoma
what happens to a thyroid mass when you swallow/ stick tongue out
it moves
what types of differentiated thyroid cancers are there and what type of prognosis is associated
papillary and follicular - good
what is the most common thyroid cancer, how does it spread and where does it commonly spread to
papillary carcinoma, spreads via lymphatics –> lungs, bone, liver, brain
what commonly causes papillary thyroid cancer and what is it associated with
RADIATION - hashimotos thyroiditis (hypo)
what is the 2nd most common cancer, how does it spread
follicular, haematogenous - minimally invasive usually
what commonly causes follicular carcinoma
low iodine diet
what is medullary thyroid carcinoma and what is the tumour marker
rare tumour of parafollicular cell - calcitonin tumour marker
what types of medullary cancer are there
sporadic MTC, familial non MEN, familial MEN2a, hyperparathyroidism
what symptoms are associated with medullary cancer
diarrhoea and flushed skin
who typically presents with thyroid lymphoma
old lady with history of AUTOIMMUNE hypothyroid and a rapid onset
what is the course of management for thyroid lymphoma
biopsy –> steroids –> chemo –> radio
what is the most aggressive thyroid tumour
anaplastic
what is important to ask about in history
radiation, FH and iodine
what is the gold standard investigation for thyroid cancer
USS fine needle aspiration
what is the normal level of TSH
0.4-4
what does thy2 mean vs thy4-5
thy2 = benign, thy4-5 = malignant
what are red flags for malignancy (6)
new nodule ages <20 or >50, male, growing, >4cm, radiation exposure, vocal cord palsy
what is considered a low risk tumour and how to you treat it
under 50, <4cm - lobectomy and keel low TSH
how do you treat a high risk tumour
subtotal/ total thyroidectomy, keep TSH <1
what follow up is required after surgery
keep low TSH, supplement T3/4, iodine scan, REMNANT ABLATION if needed
