Thyroid papillary cancer
What is thyroid papillary cancer? Who gets it?
Thyroid papillary cancer accounts for 80% of all thyroid cancers in areas where iodine is sufficient.
It occurs more frequently in children and people exposed to radiation.
The rates are twice as high in women as in men. It is more common between the ages of 30-40. Papillary cancer is the cancer of the thyroid with the best results.
Most of the time, with appropriate treatment, patients live normal lives.
How is thyroid papillary cancer diagnosed?
Thyroid papillary cancer is diagnosed by fine needle biopsy of the thyroid mass or lymph node.
Then, neck ultrasonography and sometimes neck tomography are performed to understand the condition of the neck lymph nodes.
How is thyroid papillary cancer treated?
The primary treatment for papillary thyroid cancer is surgery.
If suspicion of papillary cancer is detected by fine needle biopsy, the suspicious thyroid lobe (lobectomy) and the tissue between the two lobes (istmusectomy) are surgically removed. If cancer is diagnosed in the pathology report of the removed lobe, the other lobe is also removed by surgery.
If a definitive diagnosis of cancer is made by fine needle biopsy, the thyroid gland is completely removed (total thyroidectomy).
If suspicious lymph nodes are detected during the neck ultrasonography performed before the surgery or during the surgery, the lymph nodes on that side of the neck are also removed in the same surger .
After the surgery, the patient is given thyroid hormone supplements .
If necessary, RAI treatment is given and close monitoring is carried out for recurrence.
Thyroid follicular cancer
What is follicular thyroid cancer?
Follicular cancers constitute 10% of thyroid cancers.
It is more common in areas with iodine deficiency.
It is 3 times more common in women than in men. It occurs on average around the age of 50.
The patient is over 50 years old,
Tumor size larger than 4 cm,
higher tumor grade,
Marked vascular involvement,
Cancer has spread beyond the thyroid or
The presence of distant metastases at the time of diagnosis indicates that the course of follicular cancer is more dangerous.
What are the symptoms of thyroid follicular cancer?
Follicular cancers usually present as solitary thyroid nodules.
Sometimes there is a history of rapid size increase and long-standing goiter.
Pain is rare unless there is bleeding into the nodule.
Unlike papillary cancers, the risk of spread to the neck lymph node is rare.
Rarely, thyroid functions may be observed as increased.
Large follicular tumors (>4 cm) are more likely to be cancerous in older men.
How is thyroid follicular cancer diagnosed?
For technical reasons, it is not possible to diagnose follicular cancer with fine needle biopsy.
Therefore, genetic examinations are needed to distinguish benign follicular tumors from cancer.
Many of these genetic examinations can be performed using tissue obtained during a fine-needle biopsy.
How is thyroid follicular cancer treated?
In patients diagnosed with a follicular lesion by fine needle biopsy, only the thyroid lobe with the suspicious nodule (unilateral lobectomy) should be removed. Because actually at least 70% to 80% of these patients have benign adenomas.
Due to the higher risk of cancer (50%), all thyroid tissue is removed (total thyroidectomy) in elderly patients with follicular lesions larger than 4 cm, in cases of atypical cells seen in fine needle biopsy, in patients exposed to radiation, and in those with a family history of thyroid cancer.
If thyroid cancer is detected in a fine needle biopsy, all of the thyroid tissue is removed (total thyroidectomy). If the diagnosis of cancer is confirmed after unilateral surgery, it would be appropriate to remove the remaining thyroid lobe (complementary lobectomy).
Neck lymph nodes are not removed unless necessary.
Except for some cases, there is no need for RAI treatment.
In cases where all of the thyroid tissue is removed, the patient is given thyroid hormone supplements for lifetime.
Thyroid Hürthle cell cancer
What is Hürthle cell thyroid cancer?
Hürthle cell cancers account for approximately 3% of all thyroid cancers.
For technical reasons , it cannot be diagnosed by FNAB.
It is a type of cancer that has a slightly worse course than other thyroid cancers.
How is Hürthle cell thyroid cancer treated?
If the diagnosis of Hürtle cell cancer is certain, all thyroid tissue is removed (total thyroidectomy) .
If the diagnosis cannot be made definitively but there is doubt, the suspicious thyroid lobe is first removed (unilateral lobectomy and isthmusectomy). Then, depending on the results, the remaining thyroid lobe is removed (complementary lobectomy). In these patients, the lymph nodes in the area where the thyroid tissue is located are also removed (central lymph node dissection).
If suspicious lymph nodes are detected by examination or ultrasonography in the lymph nodes in the neck, they should also be removed (neck dissection).
RAI treatment can be applied after surgery, although its effectiveness has not been fully proven.
Thyroid hormones also need to be given as medication.
Thyroid medullary cancer
What are the symptoms of thyroid medullary cancer?
Medullary thyroid cancer accounts for approximately 5% of thyroid cancers.
It is slightly more common in women than in men. It occurs more frequently around the age of 50-60.
In some cases, it may also occur as a component of some familial diseases.
Patients often present with a mass in the neck. There may be palpable lymph nodes in the neck.
Pain, difficulty swallowing, shortness of breath and hoarseness may occur.
They can spread through the blood to the lungs, liver and bone. For this reason, complaints related to these tissues and organs may occur.
How is thyroid medullary cancer diagnosed?
The diagnosis of thyroid medullary cancer is made by laboratory tests and fine needle biopsy.
In addition, the status of the tumor and neck lymph nodes is determined by neck ultrasonography.
How is thyroid medullary cancer treated?
Treatment of thyroid medullary cancer is performed by surgically removing all of the thyroid tissue (total thyroidectomy) and removing the lymph nodes in that area (central lymph node dissection).
Additionally, if there are suspicious lymph nodes in the neck, they are also removed (neck dissection).