KALAIVANI RAMACHANDRAN012010090052

Thyroid & Tumors

Thyroid

• Hormonal gland

• Below Adam’s Apple

• Produces T3, T4, and Calcitonin

• Heart rate, metabolism, growth, blood pressure

• Feedback Mechanism

FREQUENCY

17,000 cases diagnosed annually. Women 3 times more than men. Peak incidence 30-40s. Papillary, follicular, medullary, anaplastic, lymphoma, and sarcoma

Types

• Papillary Carcinoma–80%

• Follicular Carcinoma–15%

• Medullary Carcinoma–3%

• Anaplastic Carcinoma

Papillary thyroid cancer (75% to 85% of cases [6]) – often in young females – excellent prognosis. May occur in women with familial adenomatous polyposis and in patients with Cowden syndrome. Follicular thyroid cancer (10% to 20% of cases [6]); occasionally seen in patients with Cowden syndrome Medullary thyroid cancer (5%[6] to 8% of cases)- cancer of the parafollicular cells, often part of multiple endocrine neoplasia type 2.[7] Poorly differentiated thyroid cancer Anaplastic thyroid cancer (Less than 5%[6]). It is not responsive to treatment and can cause pressure symptoms. Others

Thyroid lymphoma Squamous cell thyroid carcinoma

Sarcoma of thyroid

-

Thyroid Malignancies Tumor type Prevalence Age Distant

Metastases Survival rate (5yr)

Papillary thyroid carcinoma

85-90% 20-50 5-7% >90%

Follicular thyroid carcinoma

<10% 40-60 20% >90%

Poorly differentiated thyroid carcinoma

Rare-7% 50-60 30-80% 50%

Undifferentiated thyroid carcinoma

2% 60-80 20-50% 1-17%

Medullary thyroid carcinoma

3% 30-60 15% 30-80%

Nature Reviews. April 2006, p.292 306.

Etiology/Risk Factors

Arise from the two cell types in the gland. Follicular cells make papillary, follicular, and anaplastic. C-cells produce medullary. Radiation exposure (papillary). Populations with low dietary iodine have a higher proportion of follicular

and anaplastic cancers.

Risk Factors

• Radiation High dose x-rays or radioactive fallout

• Family History Goiters or Colon Growths Mutated RET gene

• Gender Females

• Iodine Levels• Seafood/Shellfish Consumption

Not all thyroid cancers produce symptoms. When symptoms do occur they may consist of:

lumps or nodules in front of the neck (single or multiple) enlarged lymph nodes in the neck problems with swallowing hoarseness or voice changes pain or discomfort in the neck chronic cough

Investigations

Physical exam:lumps (nodules), checks neck and nearby lymph nodes for growths or swelling. Blood tests: check for abnormal levels of (TSH) in the blood. Too much or too little TSH means the thyroid is not working well. If medullary thyroid cancer, check for a high level of calcitonin. Ultrasound: make a pattern of echoes as they bounce off organs inside your neck. The picture can show thyroid nodules that are too small to be felt, to learn the size and shape of each nodule and whether the nodules are solid or filled with fluid. Nodules that are filled with fluid are usually not cancer. Nodules that are solid may be cancer. Thyroid scan: swallow a small amount of a radioactive substance (such as radioactive iodine), and it travels through the bloodstream. Thyroid cells that absorb the radioactive substance can be seen on a scan. Nodules that take up more of the substance than the thyroid tissue around them are called “hot” nodules. Hot nodules are usually not cancer. Nodules that take up less substance than the thyroid tissue around them are called “cold” nodules. Cold nodules may be cancer. Biopsy: A biopsy is the only sure way to diagnose thyroid cancer, checks a sample of thyroid tissue for cancer cells using a microscope.

Hand Foot Syndrome

Treatment

• Surgery• Chemotherapy• Radioactive Iodine Therapy• Thyroid Hormone Therapy• External Radiation Therapy• RS5444

REFERENCE

http://www.medicinenet.com/thyroid_cancer/page4.htm#thyroid_cancer_symptoM http://www.authorstream.com/Presentation/rxhope-561111-who-classification-of-thyroid-tumors/ Bailey's & Love