Differentiated thyroid carcinoma

Differentiated carcinoma is the most common malignity of glandula thyroidea. We distinguish:
 * 1) Papillary carcinomas – grow slowly x tendency to local  recurrences, metastasize mainly to the cervical lymphatic nodes. Thyroid papillary carcinoma histopathology (4).jpg
 * 2) Follicular carcinomas – metastasize hematogenously (bones, lungs).

Clinical characteristic

 * A solitary growing knot of solid consistency (sometimes already in the present goiter – faster growth + change in appearance at USG;
 * in an advanced stage – nodal metastases of the neck (less frequent distant metastases);
 * thyroid function is not altered (x functionally active metastases may be a source of hyperthyresis).

Diagnosis

 * Lymph node with papillary thyroid carcinoma.jpgcal characteristic, USG, aspiration biopsy with the cytological examination.

Therapy

 * Total thyroidectomy  (optionally in combination with selectively modified block neck resection;
 * radioiodine therapy;
 * external beam radiotherapy;
 * substitution-suppression therapy (synthetic analogs of thyroid hormones – levothyroxine, replaces missing hormones and inhibits TSH in the pituitary gland).

Thyroglobulin is used as an early marker of recurrence/metastasis.

Prognosis

 * Very good with early detection of the disease;
 * worse in elderly patients and in distant multiple metastases.

Related articles

 * Thyroid tumors
 * Anaplastic thyroid cancer
 * Medullary thyroid carcinoma