Papillary car. Follicular car. Medullary car. Anaplastic thyroid car.

Most common esp. 30-50 y/o pts -Neuroend. neo of Older age pts
young individual parafollicular c. ->
(rare aftr 40 y/o) calcitonin
metas Blood = coom. lung Blood = Lymph + blood Pulmonary metas. comm
lung/bone/liver Regional LN Local invasion =
Lymph= uncomm lung/bone/liver Recurrent laryngeal n.
->Horseness
CF -Slowly growing -Slowly growing -1 @ both thyroid lobes Trachea -> dyspnoe/stridor
solitary -Painless enlarge Esophagus -> dysphagia
-Painless mass in -Solitary cold thyroid -50% pts = cervical LN Cervical symph. n. ->
neck nodule enlarge Horner syn
-1/3 pts -> palpable -May occur sporadic @ (pupil contract/
cervical LN inherited MEN II ( mult. enopthalmus/ palpebral
*misinteprete as lat. Endo. Syn) fissure narrowed/ loss
Abberramt thyroid* - diaerrhea + flushing sweating in face + neck)
-Rapidly grow + highly
malignant
prognosis 10 yr survival rate 10 yr survival rate = Depend on size, capsular Death w/in 6 mnth d(x)
= 90% 50% @ vascular invasion,
metastases, degree of
histo
M(x) -Total @ near total -Total thyroidectomy -Prophylactic -Surgery -> relieve
thyroidectomy preservd parathyroid thyroidectomy comprssion
-Involved LN -> - T4 routinely Child 5 y/o MEN IIa Radio + chemo
resected ->suppress TSH sect Child 1 y/o MEN IIb
-Hormone rplcmnt -if post-opt -Total thyroidectomy
therapy -> radioisotope show + LN dissection in sntrl
monitored TSH ↑uptake in neck + cmptmnt of neck
skeleton ->
therapeutic dose of
radioiodine
-if aftr surgery detect
Thyroid
thyroglobulin -> ca.
recurrent
Pathogenesis
 Genetic – MEN
 Ionizing radiation
 Preexisting thyroid dz – long standing multi nodular goiter +
iodine def