Take the Latest AccessSurgery Quick Test on Thyroid Cancer!

AccessSurgery's Quick Test lets you test your surgical knowledge and anonymously compare your results to those of your peers. Sign up for our free AccessSurgery e-newsletter and twice a month Quick Test will appear in your email inbox. Quick Test is developed by Gerard M. Doherty, MD, AccessSurgery's Editor-in-Chief, from the site's online resources. Your results will be ranked against those of your peers. Quick Test posted on 11.29.11: Thyroid Cancer Malignant Tumors of the Thyroid   Essentials of Diagnosis  History of irradiation to the neck in some patients. Painless or enlarging nodule, dysphagia, or hoarseness. Firm or hard, fixed thyroid nodule; ipsilateral cervical lymphadenopathy. Normal thyroid function; nodule stippled with calcium (x-ray), cold (radioiodine scan), solid (ultrasound); positive or suspicious cytology. Family history of thyroid cancer.   General Considerations   An appreciation of the classification of malignant tumors of the thyroid is important, because thyroid tumors demonstrate a wide range of growth and malignant behavior. At one end of the spectrum is papillary adenocarcinoma, which usually occurs in young adults, grows very slowly, metastasizes through lymphatics, and is compatible with long life even in the presence of metastases (Figure). At the other extreme is undifferentiated carcinoma, which appears late in life and is nonencapsulated and invasive, forming large infiltrating tumors composed of small or large anaplastic cells. Most patients with anaplastic thyroid carcinoma succumb as a consequence of local recurrence, pulmonary metastasis, or both within 6 months. Between these two extremes are follicular, Hürthle cell, and medullary carcinomas, sarcomas, lymphomas, and metastatic tumors. The prognosis depends on the histologic pattern, the age and sex of the patient, the extent of tumor spread at the time of diagnosis, whether the tumor takes up radioiodine, and other factors. Survival rates after thyroidectomy for papillary, mixed papillary-follicular, follicular, medullary, and undifferentiated thyroid cancer.

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