Description
The most common surgical approach for thyroid cancer is a total thyroidectomy, which involves removing the entire thyroid gland. In some cases, a partial thyroidectomy may be performed if the cancer is confined to one lobe of the thyroid gland. Minimally invasive techniques such as endoscopic or robotic-assisted thyroid surgery may be used for smaller tumors or when preservation of the thyroid gland is desired. In some cases, lymph node dissection may also be performed to remove cancerous lymph nodes in the neck.
Résumé
- The session focuses on differentiating and treating non-papillary thyroid cancers, highlighting the histology of the thyroid gland with follicular and parafollicular cells. Follicular thyroid cancer, the second most common type, spreads via vascular channels and may present with distant metastasis. It is treated with surgery and radioactive iodine.
- FNAC cannot differentiate between follicular adenoma and carcinoma, requiring histopathology for diagnosis based on capsular and vascular infiltration. Prognosis is generally good with high survival rates, although high-risk populations and those with distant metastasis have a poorer outlook.
- Anaplastic thyroid cancer is highly aggressive, with a mortality rate exceeding 90%, and presents predominantly at stage 4. Its diagnosis is vital, especially in longstanding nodules, exhibiting spindle, pleomorphic giant cell, or squamoid histology.
- Surgery is variably effective, often necessitating external beam radiation and chemotherapy for survival. Research focuses on mutations in anaplastic carcinoma to develop more effective treatments. Tyrosine kinase inhibitors and immunotherapies can only give two to three months to overall survival benefit.
- Medullary thyroid cancer originates from parafollicular C cells, often with familial associations. It commonly presents posteriorly, involving the nerve. Unlike papillary cancer, FNAC typically yields a Bethesda 5 diagnosis.
- Medullary thyroid cancer is associated with MEN syndromes and requires specific workup including serum markers. Surgical treatment involves total thyroidectomy with central neck dissection and lateral neck dissection if positive. Serum calcetonin and CEA levels are crucial for monitoring disease progression.
Exemple de certificat
À propos des intervenants
Dr Avinash Chaitanya
MBBS, MS(ENT), Head and Neck Onco Surgeon, Care Hospitals, Hyderabad
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