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Monday, 25.09.2023, 15:55
Main » Oncology » Thyroid cancer Diagnosis, Prognosis,Treatment 
Thyroid cancer Diagnosis, Prognosis,Treatment

Thyroid cancer Diagnosis, Prognosis,Treatment

Thyroid cancer - a tumor that develops from the epithelial cells of the thyroid gland. The prevalence of thyroid cancer around the world is low - about 1-2% of the cancer. In the absence of radiation exposure the incidence of thyroid cancer increases with age. If you have children, it is extremely rare, that in persons over 60 years, half of the cases can be identified nodal forms of cancer. The Chernobyl accident showed that the exposure of children, including in utero exposure, dramatically increasing the incidence of thyroid cancer. The reason is that the radioactive iodine accumulates in the thyroid gland, which is developing in utero and in infancy is much more sensitive to the action of irradiation. In adults, the same trend is observed, but much less pronounced, because for tumor development requires much higher doses and time for the manifestation of pathology.

International classification of tumors of the thyroid gland highlights:
  • benign tumors of epithelial
  • epithelial malignancies
  • Nonepithelial tumor.

There are the following histologic types of cancer:
  • Papillary thyroid cancer (about 60-70% of cases)
  • follicular thyroid cancer (15-20%)
  • Mixed carcinoma (5-10%)
  • medullary carcinoma (5%)
  • lymphoma of the thyroid gland (2-3%)
  • anaplastic carcinoma (2-3%)

Great prognostic significance was histological form of cancer. Papillary and mixed forms have the best prognosis and benign course. Other species have a significantly worse prognosis. Thus, the degree of danger followed by follicular carcinoma. But is particularly aggressive lymphoma and anaplastic carcinoma, which usually are fatal within 5 months from onset.

Prognosis also depends on the patient's age. The best prognosis - in middle age, the worst - in people younger than 20 and older than 60 years.

The clinical picture of thyroid cancer can be worn for a long time and appear only in the presence of nodes. The problem is just that noncancerous nodes are much more likely to carry out what makes a differential diagnosis.

As in other areas of oncology are 4 stages of the disease:

Stage I - local tumor without deforming the capsule of the thyroid gland without metastases;

Stage IIA - solitary tumor with deformation of cancer, as well as multiple tumors without deforming the capsule and without metastases;

Stage IIb - a tumor with the presence of unilateral metastatic lymph nodes;

Stage III - the tumor with invasion capsule, sometimes with signs of compression of adjacent organs and tissues, and tumors with a bilateral lesion of the lymph nodes;

Stage IV - tumor germinating surrounding organs or tissue. The tumor with the nearest and (or) distant metastases.

Diagnosis of thyroid cancer include:
  • examination of the thyroid gland
  • thyroid imaging (ultrasound, CT, MRI)
  • radioisotope (polyfunctional) A study of the thyroid gland
  • biopsy (the primary method of verification of cancer)
  • biochemical studies (to determine the level of hormones involved in regulating the activity of the thyroid gland - TSH, T3, T4).

Once the diagnosis is selected one of the most appropriate treatment. The most common is the surgical removal of the thyroid gland. In benign disease course, a good prognosis, the small size of the tumor and the corresponding histological picture of the organ conducting the operation. In the worst prognosis shows subtotal and total thyroidectomy. As an additional method of use of combined treatment with radioactive iodine (50-150 mCi I-131). In recurrent cancer radiation dose increased.

Treatment of aggressive forms of thyroid cancer also agreed to start with surgery, but the anaplastic form of thyroid lymphoma, and are difficult to cure. As a palliative method using radiation therapy and chemotherapy.

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