In thyroid carcinoma – colloquially called thyroid cancer – (synonyms: Adenocarcinoma of Hürthle cells; adenocarcinoma of the thyroid; anaplastic thyroid carcinoma; angiosarcoma of the thyroid; malignant neoplasm of the thyroid; malignant neoplasm of thyroglossal duct; malignant Hürthle cell tumor; malignant goiter; C-cell carcinoma; follicular carcinoma of thyroid; follicular thyroid carcinoma; Graham tumor; Hürthle cell carcinoma; Langhans goiter; malignant goiter; medullary thyroid carcinoma; medullary thyroid carcinoma (C-cell carcinoma); non-encapsulated sclerosing tumor of the thyroid; papillary thyroid carcinoma; parafollicular carcinoma; thyroid cancer; undifferentiated (anaplastic) thyroid carcinoma; ICD-10 C73. ) is a malignant neoplasm (malignant neoplasm) of the thyroid gland. Thyroid carcinoma is the most common malignant neoplasm of the endocrine (hormone) system. Different forms of thyroid carcinoma can be distinguished:
- Papillary thyroid cancer (PTC; approximately 50-60%, increasing trend).
- Follicular thyroid carcinoma (engl. follicular thyroid cancer, FTC; 20-30 %).
- Medullary thyroid cancer (C-cell carcinoma; Engl. medullary thyroid cancer, MTC; secretes calcitonin; about 5-10%).
- Poorly differentiated thyroid cancer (PDTC).
- Anaplastic thyroid carcinoma (undifferentiated thyroid cancer; engl. anaplastic thyroid cancer, ATC; approx. 1-5 %).
- Rare forms such as malignant lymphoma (cancers of the lymphatic system/lymph nodes, tonsils or spleen) or sarcoma (malignant tumors originating either in soft tissue (e.g., connective tissue, adipose tissue, muscle tissue) or bone)
- Metastases (daughter tumors) of other tumors.
Sex ratio: males to females is 1: 3 (differentiated carcinoma). In medullary thyroid carcinoma (C-cell carcinoma) and undifferentiated (anaplastic) thyroid carcinoma, the sex ratio is balanced. In the United States, 74% of thyroid carcinomas are diagnosed in women. Peak incidence: disease occurs predominantly in the 5th decade of life, earlier for medullary thyroid carcinoma. The median age of onset is approximately 55 years in women and 56 years in men. The incidence (frequency of new cases) of thyroid carcinoma is 7.5-9 cases per 100,000 population per year for women and 3.2-4 cases per 100,000 population per year for men (in Germany). In Austria, the incidence is approximately 9 diseases per 100,000 population per year. In the USA, 14.3 diseases per 100,000 inhabitants per year.The incidence of anaplastic thyroid carcinoma is approximately 1-2 cases per 1,000,000 inhabitants per year. Course and prognosis:Treatment of patients with thyroid carcinoma is primarily surgical (operative).Prognosis depends on the histologic (fine tissue) subtype of the carcinoma as well as the time of diagnosis. In differentiated thyroid carcinoma, the chance of cure is very good. Thyroid carcinoma is often recurrent (recurring), so consistent follow-up is important. Up to 15% of differentiated thyroid cancers (“DTC”) become radioiodine refractory (= tumor does not take up radioiodine and the disease progresses) or resistant during the course of the disease. Patients with metastatic (“with daughter tumors”) radioiodine-refractory DTC (RR-DTC) survive for a median of about 3-6 years; the 10-year survival rate is about 10%. The 5-year survival rate of follicular thyroid carcinoma is circa 80%, medullary thyroid carcinoma is 60-70%, and papillary thyroid carcinoma is 80-90%. In anaplastic (undifferentiated) thyroid carcinoma, patients often die within six months of diagnosis.
