Thyroid cancer is cancer of the thyroid gland. There are four forms: papillary, follicular, medullary and anaplastic. The most common forms (papillary and follicular) are fairly benign, and the medullary form also has a good prognosis; the anaplastic form is fast-growing and poorly responsive to therapy. more...
Masses of the thyroid are diagnosed by fine needle aspiration (FNA) or frequently by thyroidectomy (surgical removal and subsequent pathological examination). As the thyroid concentrates iodine, radioactive iodine is a commonly used modality in thyroid carcinomas.
Most often the first symptom of thyroid cancer is a nodule in the thyroid region of the neck, but only 4% of these nodules are malignant. Sometimes the first sign is an enlarged lymph node. Other symptoms that can be present are pain, changes in voice and symptoms of hypo- or hyperthyroidism.
After a nodule is found during a physical examination, thyroid function is investigated by measuring, among other markers, Thyroid Stimulating hormone (TSH), the thyroid hormones thyroxine (T4) and triiodothyronine (T3), and Thyroid Binding Globulin (TBG). Tests for serum thyroid autoantibodies are also sometimes done. The blood assays are usually accompanied by ultrasound imaging of the nodule to determine the position, size and texture. Most clinicians will also request technetium and/or radioactive iodine imaging of the thyroid. The most cost-effective, sensitive and accurate test to determine whether the nodule is malignant is the fine needle biopsy, which is almost always done. Often, the suspected nodule is removed surgically for pathological examination, or a biopsy is done using a coarse needle, so that the arrangement of the cells can be examined (where the fine needle biopsy can only give individual cells).
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