Thyroid

Question 1

Sous types histologiques

Answer 1

1. DTC = Diffrentiated thyroid carcinoma
   PTC = Papillary thyroid cancer (BRAF mut et RET fusion, + commun)
   FTC = Follicular thyroid cancer (RAS muté)
   Hurtle cell
2. MTC = Medullary thyroid cancer
   RET mutés
3. ATC = Anaplastic thyroid cancer
   Agressif

Question 2

Facteurs de risque

Answer 2

Radiation ionisante (PTC)
Enfants
Désastres nucléaires

Question 3

Traitement du DTC = Diffentiated TC

Answer 3

1. Chx
2. Iodine radiactive
   Si: gross extrathyroidal extension, tumeur > 4 cm, postop Tg > 5-10 ng/ml

Si progression : lenvatinib, sorafenib

Question 4

Traitement du MTC = Medullary

Answer 4

1. Chx
2. Observations

Si progression :
Cabozantinib
Vandetinib
Selpercatinib (RET muté)

**Pas de RAI

Question 5

Traitement ATC= anaplasique

Answer 5

1. Chx
2. Supportive care (EBRT, chimio = carbo-taxol, taxotère doxo, taxol, doxo)
   Si BRAFV600E : Dabrafenib + trametinib