Thyroid Cancer Overview and Epidemiology

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Questions and Answers

What is a typical age range for the appearance of thyroid cancer?

  • 30-50 years
  • 60-75 years
  • 40-65 years (correct)
  • 20-35 years

What is the approximate ratio of women to men affected by thyroid cancer?

  • 4/1
  • 1/2
  • 1/1
  • 2/1 (correct)

External irradiation of the head and neck is a main risk factor for what type of thyroid cancer?

  • Medullary thyroid cancer
  • All types of thyroid cancer
  • Papillary and follicular cancers (correct)
  • Anaplastic thyroid cancer

Which of the following is often the initial presentation of thyroid cancer?

<p>Asymptomatic thyroid nodule (A)</p> Signup and view all the answers

Which imaging investigation is considered the method of choice for thyroid nodules?

<p>Thyroid scintigraphy (C)</p> Signup and view all the answers

What does a 'cold' nodule signify in thyroid scintigraphy?

<p>Suspicion of malignancy (B)</p> Signup and view all the answers

Which diagnostic procedure is used to obtain cell samples from thyroid nodules?

<p>Puncture biopsy (B)</p> Signup and view all the answers

What is the maximum size for a tumor classified as T2 under the TNM classification of thyroid cancers?

<p>Between 2 and 4 cm (B)</p> Signup and view all the answers

What is the initial treatment recommended for stages I and II of papillary and follicular thyroid cancers?

<p>Total thyroidectomy or lobectomy followed by I131 administration (D)</p> Signup and view all the answers

Which treatment is primarily used for stage IV thyroid cancers that do not capture I131?

<p>Only external irradiation (A)</p> Signup and view all the answers

Which type of thyroid cancer has the worst prognosis, according to the information provided?

<p>Anaplastic thyroid cancers (D)</p> Signup and view all the answers

What is the survival rate at 5 years for follicular carcinomas?

<p>75% (D)</p> Signup and view all the answers

What is a common consequence of radical surgical interventions for thyroid cancers?

<p>Hypothyroidism (D)</p> Signup and view all the answers

What is the classification for anaplastic intrathyroidal carcinoma?

<p>T4a (D)</p> Signup and view all the answers

Which of the following stages applies when a papillary carcinoma is diagnosed in a patient aged 48 with T2 N0 M0?

<p>Stage II (B)</p> Signup and view all the answers

Which thyroid carcinoma type represents more than 90% of cases?

<p>Papillary (A)</p> Signup and view all the answers

What does M0 indicate in cancer staging?

<p>Without the presence of distant metastases (B)</p> Signup and view all the answers

What is a common factor that negatively affects prognosis in differentiated cancers?

<p>Extension of the tumor through the thyroid capsule (D)</p> Signup and view all the answers

What classification is given to extrathyroid anaplastic carcinoma?

<p>T4b (C)</p> Signup and view all the answers

What type of cancer stage includes 'any T, any N, M1'?

<p>Stage IV (D)</p> Signup and view all the answers

What is the primary route of dissemination for undifferentiated carcinomas?

<p>Hematogenous (D)</p> Signup and view all the answers

Flashcards

Total Thyroidectomy

Surgical removal of the entire thyroid gland. Used for stages I and II papillary or follicular thyroid cancers.

Lobectomy

Removal of a part of the thyroid gland.

I-131 Administration

Radioactive Iodine (I-131) used to destroy remaining thyroid tissue.

Cervical Lymphadenectomy

Removal of lymph nodes in the neck.

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Hormone Replacement Therapy

Treatment for hypothyroidism after thyroid surgery.

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TNM staging

A system used to classify cancers based on tumor size (T), lymph node involvement (N), and distant metastases (M).

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T (Tumor) stage

Describes the size and extent of the tumor. It ranges from T1 (smallest) to T4 (most invasive).

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N (Node) stage

Indicates if the cancer has spread to nearby lymph nodes.

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M (Metastasis) stage

Refers to distant spread of the cancer.

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Papillary thyroid cancer

A type of thyroid cancer that grows slowly and is more common than other types.

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Follicular thyroid cancer

A type of thyroid cancer that grows slowly and is often found at an early stage.

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Medullary thyroid cancer

A type of thyroid cancer that is less common but can be aggressive.

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Anaplastic thyroid cancer

A type of thyroid cancer that is rare but aggressive and grows quickly.

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Thyroid cancer prevalence

Thyroid cancer is the most common type of endocrine cancer, accounting for approximately 1% of all malignancies.

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Thyroid cancer demographics

Thyroid cancer typically affects individuals between the ages of 40 and 65. Women are more likely to develop thyroid cancer than men, with a ratio of 2:1.

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Radiation and thyroid cancer

Exposure to external radiation, particularly to the head and neck, is a significant risk factor for papillary and follicular thyroid cancers. This risk has been demonstrated after atomic bomb attacks and nuclear accidents.

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Genetics and medullary thyroid cancer

Genetic factors play a crucial role in the development of medullary thyroid cancer.

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Symptoms of thyroid cancer

Thyroid nodules, often asymptomatic, are the most common initial sign of thyroid cancer. As the nodule grows, it can cause compression symptoms, and in advanced stages, pain and difficulty swallowing may occur.

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Ultrasound in thyroid cancer

Ultrasound imaging is useful for identifying thyroid nodules and differentiating between solid and liquid content.

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Scintigraphy in thyroid cancer

Thyroid scintigraphy is the gold standard imaging technique for thyroid cancer. It involves administering radioactive iodine or technetium and observing the uptake by the thyroid tissue. "Cold" nodules, which don't absorb the tracer, are suspicious for malignancy.

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Biopsy in thyroid cancer

Fine-needle aspiration biopsy is a procedure that involves collecting cells from the thyroid nodule with a needle. This is done to identify the nature of the nodule and determine if it is cancerous.

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Study Notes

Thyroid Cancer Overview

  • Most common endocrine cancer, about 1% of all malignancies.

Epidemiology

  • Typically affects those aged 40-65, with women more affected (2:1 ratio).

Risk Factors

  • Papillary/follicular cancers: Exposure to radiation (e.g., atomic bomb, Chernobyl).
  • Medullary cancer: Strong genetic factors.

Clinical Diagnosis

  • Often presents as an asymptomatic nodule, with symptoms like pain and dysphagia in later stages. Lymph node metastasis occurs in <5% of cases.

Paraclinical Diagnosis

  • Ultrasound: Helps identify nodule type.

Thyroid Scintigraphy

  • Cold nodules (non-radioactive) may indicate malignancy, but only 10% are cancerous.

Puncture Biopsy

  • Needle biopsy for nodule testing, with imaging for metastases (chest X-ray, liver ultrasound).

Biological Markers

  • Elevated calcitonin and CEA levels suggest medullary carcinoma.

TNM Classification

  • T: Tumor size and extent.
  • N: Lymph node involvement.
  • M: Metastasis.

Staging

  • Staging varies for papillary, follicular, medullary, and anaplastic cancers by age and tumor type.

Histopathology

  • Types: Papillary, follicular (90%), medullary (5-10%), anaplastic (rare).

Evolution and Complications

  • Spread via lymphatic system and bloodstream; lung, bones, liver, kidneys, and brain can be affected.

Prognostic Factors

  • Poor prognosis: large tumors (>5 cm), older age (>40), metastasis, and anaplastic type.

Treatment

  • Surgery (thyroidectomy) + Iodine-131 for papillary/follicular (stages I-II).
  • Radiotherapy or chemotherapy for advanced cases (Stage III-IV, anaplastic).

Post-Surgery Complications

  • Hypothyroidism requiring hormone replacement therapy.

Results

  • Young patients and differentiated cancers (papillary/follicular) have better outcomes.

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