Definition
Malignant lesions of the thyroid gland. Papillary and follicular are known as differentiated carcinomas. Anaplastic and medullary are poorly or undifferentiated carcinomas.
Key Points
- Many thyroid cancers found in young adults. Occasionally occur in childhood.
- Isolated thyroid lumps should always be investigated to confirm a cause.
- The prognosis is often good with surgical resection and medical adjuvant treatment.
- All patients should be managed by an MDT.
Epidemiology
Male:female 1:2. Peak incidence depends on histology (papillary, young adults; follicular, middle age; anaplastic, elderly; medullary, any age).
Pathology
Histology of thyroid malignancies.
Aetiology
Predisposing factors:
- Pre-existing goitre.
- Previous radiation of the neck.
- Thyroid cancer in first degree relative.
Clinical Features
- Papillary: solitary thyroid nodule.
- Follicular: slow-growing thyroid mass, symptoms from distant metastases.
- Anaplastic: rapidly growing thyroid mass causing tracheal and oesophageal compression.
- Medullary: thyroid lump, may have MEN IIA (medullary thyroid carcinoma, phaeochromocytoma, hyperparathyroidism) or MEN IIB (medullary thyroid carcinoma, phaeochromocytoma, multiple mucosal neuromas, Marfanoid habitus) syndrome or familial medullary thyroid cancer (FMTC).
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