Thyroid Neoplasms Flashcards
1
Q
What are the most common types of thyroid malignancies?
A
Papillary (80%), follicular (10%), medullary and anaplastic
2
Q
What are the risk factors for development of a thyroid neoplasm?
A
- Iodine deficiency (adenoma only)
- Head and neck radiation
- Female sex
- 20-40 age
3
Q
What are the likely history findings with a thyroid neoplasm?
A
- Mass effect of nodule (SOB, dysphagia, voice change)
- Thyrotoxicosis (more in adenomas than malignancies)
- Weight loss
- Hyperphagia
- Heat intolerance
- Nervousness
- Palpitations
- Oligomenorrhoea
- SOB
- Tremor
4
Q
What investigations might you order in someone suspected of a toxic thyroid adenoma? How would this differ in malignancy?
A
- TFTs
- If normal, suspect malignancy and jump to)
- FNA/biopsy
- Ultrasound/CT
- If normal, suspect malignancy and jump to)
- Scintigraphy
- Laryngoscopy
- Ultrasound
- TSH antibodies
- ECG
5
Q
How are toxic thyroid adenomas managed?
A
- Medical management of adenoma
- Radioactive iodine ablation, thiamazole
- Surgical resection of mass
6
Q
How are thyroid malignancies managed?
A
- Papillary/follicular
- Surgery, radioactive iodine, TSH suppression (levothyroxine)
- Medullary/anaplastic
- Surgery, thyroxine with/without chemoradiotherapy
