Thyroid Gland Flashcards
Vasculature to the thyroid gland
Arterial - superior and inferior thyroid
Venous - superior, middle and inferior thyroid arteries
Complications of thyroidectomy
Recurrent laryngeal nerve damage
Accidental removal of parathyroid glands leading to hypocalcaemia
Investigations of thyroid nodules
Thyroid function tests
Ultrasound guided fine needle aspiration
If any doubt, carry out diagnostic hemithyroidectomy
What are the histological classifications of benign and malignant thyroid neoplasms?
Benign:
Adenoma - mainly follicular
Malignant: Papillary adenocarcinoma (70%) Follicular carcinoma (20%) Medullary carcinoma (5%) Anaplastic carcinoma (5%)
Typical features of papillary adenocarcinoma
Seen in younger patients
History of irradiation of the neck
Spreads via lymphatics
Typical features of follicular carcinoma
Spreads via lymphatics and blood
Often metastasises to bones and lungs
Typical features of medullary carcinoma
Neoplasm of the calcitonin regulating C cells
Typically seen in multiple endocrine neoplasia (MEN syndrome)
Poor prognosis
Typical features of Anaplastic carcinoma
Older patients
Poor prognosis, very invasive
Often presents late
Management of non neoplastic thyroid nodules
Conservative
Surgery - hemithyroidectomy
Management of benign neoplastic thyroid nodules
No further treatment required after diagnostic hemithyroidectomy
Management of malignant neoplastic thyroid nodules
Surgery - total thyroidectomy for papillary, follicular and medullary carcinoma (Anaplastic disease is too advanced for curative surgery)
Radio-iodine surgery - for papillary and follicular carcinoma after surgery
Complications of thyroid surgery
Post operative haemorrhage
Airway obstruction
Vocal cord palsy
Hypocalcaemia
What is the difference between a goitre and a thyroid nodule?
Goitre is an enlarged thyroid gland - may cause airway obstruction and dysphagia
A thyroid nodule is an abnormal mass in the thyroid - need to be investigated to check they aren’t neoplastic
