Thyroid carcinomas FA 330

Question 1

Complications of thyroid cancer– thyroidectomy

Answer 1

• hoarsness (recurrent laryngeal nerve damage)
• Hypocalcemia ( post-op perioral tingling)
• transaction of recurrent and superior laryngeal n. (during ligation of inferior thyroid artery and superior laryngeal artery respectively)

Question 2

Papillary carcinoma

1. frequency?
2. things you will see?
3. Mutations?

Answer 2

Most common, excellent prognosis
“Orphan annie eyes”
Psammoma bodies
Lymphatic invasion

Increased risk with RET and BRAF mutations
Childhood irrational and activation of tyrosine kinase receptor (NTRK1)

Question 3

Follicular carcinoma

1. frequency?
2. things you will see?
3. Mutations?

Answer 3

second most common, good prognosis

Invades thyroid capsule
can spread hematogenously (mostly to lymph nodes in neck)

Uniform cuboidal cells lining the follicles = uniform follicles

RAS mutation, PAX8-PPARgamma1

Question 4

follicular adenoma

1. what you see?

Answer 4

looks the same as follicular carcinoma except that it does NOT invade the fibrous capsule

• can secrete thyroid hormones = hyperthyroidism

Question 5

Medullary carcinoma

1. what cells?
2. things you will see?
3. Mutations?
4. Tx?

Answer 5

cancer from parafollicular cells

** produces CALCITONIN***

sheets of cells in an amyloid stroma
Can spread hematogenously

MEN 2A and MEN 2B

Tx: you cannot use radiation because not responsive to radiation since it is not hormone producing cell section. It is the medullary part. Surgery is the way to go on this one.

sidenote: patients have to be screened for pheochromocytoma before they can have the surgery

Question 6

Undifferentiated/ anapestic carcinoma

Answer 6

older patients, invades local structures, very poor prognosis (rock hard painless goiter)

Question 7

what cancer is associated with Hashimoto thyroiditis

Answer 7

increased risk of non-hodgkin lymphoma