Medical history (history of illness) is an important component in the diagnosis of thyroid cancer (thyroid carcinoma). Family history Is there a frequent history of thyroid disease/tumor in your family? Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). What symptoms have you noticed in … Thyroid Cancer (Thyroid Carcinoma): Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Focal thyroiditis (inflammation of the thyroid gland). Struma nodosa (nodular goiter) Thyroiditis (inflammation of the thyroid gland) Neoplasms – tumor diseases (C00-D48) Follicular adenomas (benign tumor originating from the follicular epithelium). Follicular thyroid carcinoma (about 30%). Lymphoma Medullary thyroid carcinoma (C-cell carcinoma; about 5%). Papillary thyroid carcinoma (about 60%). … Thyroid Cancer (Thyroid Carcinoma): Or something else? Differential Diagnosis
The following are the major diseases or complications that may be contributed to by thyroid carcinoma (thyroid cancer): Endocrine, nutritional, and metabolic diseases (E00-E90). Myxedema – pasty (puffy; bloated) skin that shows nonpushable, doughy edema (swelling) that is not positional; occurring primarily on the lower legs Neoplasms – tumor diseases (C00-D48). Malignant melanoma (primary melanoma) … Thyroid Cancer (Thyroid Carcinoma): Complications
Classification of thyroid carcinoma by histologic features. Carcinoma type Relative frequency Metastasis Prognosis Special features Papillary thyroid cancer (PTC). 50-60%, increasing trend lymphogenic (“on the lymphatic pathway”) 5-year survival rate: 80-90%. Thyroglobulin (tumor marker; detection after thyroidectomy is indicative of metastases/ daughter tumors) Follicular thyroid carcinoma 20-30 % Hematogenous (“in the bloodstream”) 5-year survival rate: … Thyroid Cancer (Thyroid Carcinoma): Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and the sclera (white part of the eye) [Leading symptoms: enophthalmos (retraction of the eyeball); miosis (pupillary constriction); ptosis (drooping of the eyelid)] Jaw [accompanying symptom: … Thyroid Cancer (Thyroid Carcinoma): Examination
1st-order laboratory parameters-obligatory laboratory tests. TSH, T3, T4 (usually euthyroid; possibly hyperthyroidism in differentiated follicular and papillary carcinomas). Tumor markers: Medullary thyroid carcinoma (C-cell carcinoma; medullary thyroid cancer, MTC): calcitonin, carcinoembryonic antigen (CEA). RET oncogene in familial formsNote: In addition to MTC, an elevation in serum calcitonin can be C-cell hyperplasia, renal insufficiency (process leading … Thyroid Cancer (Thyroid Carcinoma): Test and Diagnosis
Therapeutic targets Improvement of the symptomatology Elimination of tumor cells Establishment of a euthyroid metabolic state (normal thyroid function). Therapy recommendations Depending on the histology of the tumor, resection (removal) of the equilateral thyroid lobe or total thyroidectomy (thyroidectomy) with lymph node extirpation (lymph node removal) (see “Surgical Therapy” below), radioiodine therapy, radiation therapy (see … Thyroid Cancer (Thyroid Carcinoma): Drug Therapy
Mandatory medical device diagnostics. Thyroid ultrasonography (ultrasound examination of the thyroid gland) – to detect nodules [Suspicious (suspicious)/malignant (malignant) nodules: Shape: irregularly configured Border: indistinct, poorly delineated. Echo structure: solid node, solid and cystic portions. Echogenicity: echo-poor or -complex, inhomogeneous. Calcification: micro- and macrocalcification. Rim: no halo (light ring around the node). Blood flow: hypervascularization … Thyroid Cancer (Thyroid Carcinoma): Diagnostic Tests
After the diagnosis of thyroid carcinoma, the following approach should be sought depending on the histologic findings: Carcinoma type Relative frequency Therapy of choice Prognosis Papillary thyroid cancer (PTC). 50-60%, increasing trend Tumor <1 cm in diameter, well demarcated) → resection of equilateral thyroid lobe (lobectomy) and lymphadenectomy (extirpation regional lymph nodes). Tumor > 1 … Thyroid Cancer (Thyroid Carcinoma): Surgical Therapy
To prevent thyroid cancer (thyroid carcinoma), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet – iodine deficiency Overweight (BMI ≥ 25; obesity). Radiation Ionizing radiation; after head and neck CT, the risk of tumors is increased for children. This is especially true for thyroid carcinomas (increased by 78%) and brain … Thyroid Cancer (Thyroid Carcinoma): Prevention
Radiation therapy for thyroid carcinoma: Radioiodine therapy: after resection (surgical removal) of the equilateral thyroid lobe and regional lymph nodes in papillary carcinoma or total thyroidectomy (thyroidectomy) with lymph node extirpation (lymph node removal) for follicular carcinoma, as well as metastases (daughter tumors), should be followed by radioiodine therapy as posttreatment.This is a form of … Thyroid Cancer (Thyroid Carcinoma): Radiotherapy
The following symptoms and complaints may indicate thyroid cancer (thyroid cancer): Leading symptoms Derby but indolent (painless) nodules on the neck that rapidly increase in size, as well as nodules fused to the bedrock or with signs of surrounding infiltration (→ Horner syndrome* , recurrent paresis* * ) Enophthalmos* * – recession of the eyeball … Thyroid Cancer (Thyroid Carcinoma): Symptoms, Complaints, Signs
