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Endocrine SOH > Thyroid tumours > Flashcards

Thyroid tumours Flashcards

1
Q

Benign - adenoma definition

A

Glandular tumour

Usually an incidental finding but if large enough they can cause local symptoms

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2
Q

Benign adenoma - pathology

A

Encapsulated by a surrounding collagen cuff

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3
Q

What does a pituitary adenoma secrete?

A

TSH

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4
Q

Malignant thyroid tumour - definition

A

Glandular tumour

Most are derived from follicular epithelium

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5
Q

Malignant thyroid tumour - high risk

A

Age: Below 20 or over 50
High metastatic potential
Tumour >4cm

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6
Q

Management of a low risk malignant thyroid tumour

A

Lobectomy

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7
Q

Management of a high risk malignant thyroid tumour

A

Total thyroidectomy

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8
Q

Differentiated thyroid cancer - definition

A

TSH driven

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9
Q

Differentiated thyroid cancer - who gets it?

A

Males: incidence increases with age
Females: incidence increases with age until age 40

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10
Q

Differentiated thyroid cancer - cause

A

Radiation

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11
Q

Differentiated thyroid cancer - management

A

Thyroidectomy

Discharge with T3/T4 meds

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12
Q

Post op care after removal of malignant tumour

A

Check calcium levels within 24 hours
Perform whole body iodine scan 3-6 months post op
- eliminates any remaining cancer cells

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13
Q

What is used as a tumour cell marker?

A

Thyroglobulin levels

- if management has been successful, thyroglobulin levels should be undetectable

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14
Q

What is the most common thyroid cancer?

A

Papillary thyroid cancer

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15
Q

Papillary thyroid cancer - definition

A

Usually due to a solitary nodule in the thyroid

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16
Q

Papillary thyroid cancer - cause

A

Ionising radiation

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17
Q

Papillary thyroid cancer - pathology

A

Nuclei are pale
Cystic
Calcified

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18
Q

Papillary thyroid cancer - associated conditions

A

Hashimotos thyroiditis

19
Q

Papillary thyroid cancer - clinical features

A 
Patient feels 'something in their neck' 
Palpable nodules 
Cervical lymph nodes 
Hoarseness
Dysphagia
Cough 
SOB
20
Q

Papillary thyroid cancer - investigations

A

US guided FNA

21
Q

Papillary thyroid cancer - management

A

Surgery
- thyroid lobectomy / sub total thyroidectomy / total thyroidectomy

Thyroid remnant ablation
- remove any leftover thyroid tissue that was not removed at time of surgery

22
Q

What is the second most common thyroid cancer?

A

Follicular carcinoma

23
Q

Follicular carcinoma - definition

A

Usually a single nodule which slowly enlarges

24
Q

Follicular carcinoma - who gets it?

A

More common in females

25
Q

Follicular carcinoma - cause

A

Iodine deficiency

26
Q

Follicular carcinoma - ways of spreading

A

Haematogenous spread

27
Q

Papillary thyroid cancer - ways of spreading

A

Lymphatic spread

Haematogenous spread

28
Q

Follicular carcinoma - clinical features

A

Usually painless

Palpable nodules

29
Q

Follicular carcinoma - investigations

A

US guided FNA

30
Q

Follicular carcinoma - management

A

Non severe - lobectomy
Severe - thyroidectomy
Thyroid remnant ablation - to remove any left over thyroid tissue

31
Q

Medullary carcinoma (MTC) - definition

A

Derived from parafollicular cells (C cells)

High concentration of calcitonin in the blood

32
Q

Medullary carcinoma - types

A

Sporadic MTC
Familial non-MEN
Familial MEN: MEN2a or MEN2b

33
Q

Medullary carcinoma - if sporadic then it will be solitary / bilateral nodules?

A

Solitary

34
Q

Medullary carcinoma - if familial then it will be solitary / bilateral nodules?

A

Bilateral

35
Q

Medullary carcinoma - investigations

A

US guided FNA

Increased calcitonin levels

36
Q

Medullary carcinoma - management

A

Total thyroidectomy

37
Q

What is the most deadly thyroid cancer?

A

Anaplastic carcinoma

38
Q

Anaplastic carcinoma - cause

A

Radiation exposure

39
Q

Anaplastic carcinoma - who gets it?

A

Older patients

Males

40
Q

Anaplastic carcinoma - clinical features

A

Rapidly growing mass on neck
Metastasis to lymph nodes
Involvement of neck structures

41
Q

Thyroid lymphoma - definition

A

Cancer of the lymph nodes in people who have been on long standing thyroxine replacement

42
Q

Thyroid lymphoma - cause

A

Patients with a background of hashimotos thyroiditis

43
Q

Thyroid lymphoma - clinical features

A

Rapid onset of mass in the neck region

44
Q

Thyroid lymphoma - management

A

Chemotherapy / radiotherapy

Steroids

Endocrine SOH (25 decks)

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