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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
Follicular carcinoma - cause
Iodine deficiency
26
Follicular carcinoma - ways of spreading
Haematogenous spread
27
Papillary thyroid cancer - ways of spreading
Lymphatic spread | Haematogenous spread
28
Follicular carcinoma - clinical features
Usually painless | Palpable nodules
29
Follicular carcinoma - investigations
US guided FNA
30
Follicular carcinoma - management
Non severe - lobectomy Severe - thyroidectomy Thyroid remnant ablation - to remove any left over thyroid tissue
31
Medullary carcinoma (MTC) - definition
Derived from parafollicular cells (C cells) | High concentration of calcitonin in the blood
32
Medullary carcinoma - types
Sporadic MTC Familial non-MEN Familial MEN: MEN2a or MEN2b
33
Medullary carcinoma - if sporadic then it will be solitary / bilateral nodules?
Solitary
34
Medullary carcinoma - if familial then it will be solitary / bilateral nodules?
Bilateral
35
Medullary carcinoma - investigations
US guided FNA | Increased calcitonin levels
36
Medullary carcinoma - management
Total thyroidectomy
37
What is the most deadly thyroid cancer?
Anaplastic carcinoma
38
Anaplastic carcinoma - cause
Radiation exposure
39
Anaplastic carcinoma - who gets it?
Older patients | Males
40
Anaplastic carcinoma - clinical features
Rapidly growing mass on neck Metastasis to lymph nodes Involvement of neck structures
41
Thyroid lymphoma - definition
Cancer of the lymph nodes in people who have been on long standing thyroxine replacement
42
Thyroid lymphoma - cause
Patients with a background of hashimotos thyroiditis
43
Thyroid lymphoma - clinical features
Rapid onset of mass in the neck region
44
Thyroid lymphoma - management
Chemotherapy / radiotherapy | Steroids

Endocrine SOH (25 decks)

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