Thyroid Cancer

THYROID CANCER

Thyroid cancer is a malignant tumor that develops from the abnormally growing cells of the thyroid gland whose potential to spread to other parts of the body is dependent on the cancer type.

Thyroid cancer estimated new cases, in the US,  for 2018 is about 53,990. The estimated death cases are 2,060.

Symptoms can include:

Difficulties swallowing
Swelling or a lump in the neck

 

Risk factors include:

*Radiation exposure at a young age 

*Having an enlarged thyroid

*family history

 

There are four main types of thyroid cancer

*papillary thyroid cancer

*follicular thyroid cancer

*medullary thyroid cancer

*anaplastic thyroid cancer

The vast majority of low-grade follicular cell-derived thyroid carcinomas follows an indolent clinical course and is associated with very low mortality. Risk stratification using multiple clinical and tissue pathologic characteristics has become the standard of care to guide appropriate management and avoid overtreatment. Over the past few decades, the field of thyroid pathology has witnessed several major changes that significantly impacted upon patients’ care. These are: 1) The reclassification of non-invasive encapsulated follicular variant of papillary thyroid carcinoma as noninvasive follicular thyroid neoplasm with papillary-like nuclear features; 2) the diagnosis of Hurthle cell carcinoma based on the presence of capsular and vascular invasion; 3) a detailed definition of poorly differentiated thyroid carcinoma, taking into consideration mitosis and necrosis; and 4) the emphasis on a detailed pathologic analysis such as the extent of vascular invasion and extrathyroidal extension.

 Diagnosis is often based on ultrasound and fine needle aspiration.

 

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an indolent thyroid tumor characterized by frequent RAS  gene mutations and an absence of the BRAF V600E mutation commonly seen in classical papillary thyroid carcinoma (cPTC). 

nodules that were NIFTP, and a TERT promoter mutation along with an NRAS mutation in a poorly differentiated thyroid carcinoma. For nodules with an FNA diagnosis of suspicious for malignancy or malignant, cytologists can differentiate most cases of potential NIFTP/FVPTC from cPTC. However, molecular testing may be valuable for a subset of cases, especially those that are indeterminate for potential NIFTP/FVPTC versus cPTC based on cytologic features alone.

 

Treatment options may include:

Surveillance

Surgery

Radiation therapy including radioactive iodine,

Chemotherapy

Thyroid hormone

Targeted therapy

Surgery may involve removing part or all of the thyroid.

 

Five-year survival rates are 98% in the United States.

 

The information in this document does not replace a medical consultation. It is for personal guidance use only. We recommend that patients ask their doctors about what tests or types of treatments are needed for their type and stage of the disease.

Sources:

American Cancer Society

The National Cancer Institute

National Comprehensive Cancer Network

American Academy of Gastroenterology

National Institute of Health

MD Anderson Cancer Center

Memorial Sloan Kettering Cancer Center

American Academy of Hematology

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