thyroid cancer + nodules

What are benign causes of thyroid nodules?

• multinodular goitre

• cysts

• thyroid adenoma (solitary toxic thyroid nodule)

• Hashimoto’s

What are malignant causes of thyroid nodules?

• papillary carcinoma (most common)

• follicular carcinoma

• medullary carcinoma

• anaplastic carcinoma

• lymphoma

What is the first line investigation of thyroid nodules?

ultrasonography

can help determine suspicious features

What is the common epidemiology for thyroid cancer?

less than 1% of all cancers

peak incidence 40-50 years

F:M 3:1

What is the most common type of thyroid cancer?

papillary carcinoma - excellent prognosis with 10 year survival >90%

what is the second most common thyroid cancer?

follicular carcinoma

which types of thyroid cancer have a poor prognosis?

Medullary carcinoma and anaplastic carcinoma

lymphoma

what are common features of thyroid cancer?

often asymptomatic

• painless thyroid nodule or mass

• hoarseness, dysphagia, cervical lymphadenopathy

• firm, irregular, fixed, immobile mass

What are features specific to medullary thyroid cancer?

• diarrhoea

• flushing

• other symptoms relating to excess secretion of calcitonin

what are features specific to Anaplastic thyroid cancer?

• rapidly enlarging neck mass

• dysphagia

• hoarseness

• respiratory distress

What is the thyroid criteria for thyroid cancer?

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for thyroid cancer in people with an unexplained thyroid lump.

Where are common metastatic sites for thyroid cancer?

bone

lung

local invasion

How is thyroid cancer diagnosed?

• examination

• imaging

• biopsy

What are treatment options for thyroid cancer?

surgery

radioactive iodine (for left over tissue)

radiation

screening for family

What marker can be used for follicular carcinoma?

thyroglobulin