Differentiated thyroid carcinoma

Differentiated carcinoma is the most common malignity of glandula thyroidea. We distinguish:

Papillary carcinomas – grow slowly x tendency to local recurrences, metastasize mainly to the cervical lymphatic nodes.
Papillary carcinoma of the thyroid gland
Follicular carcinomas – metastasize hematogenously (bones, lungs).

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).

Metastasis of papillary carcinoma in lymphatic node
Clinical characteristic, USG, aspiration biopsy with the cytological examination.

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.

References

DÍTĚ, P. Internal Medicine. 2. edition. Praha : Galén, 2007. vol. 586. ISBN 978-80-7262-496-6.

KLENER, Pavel. Internal Medicine. 3. edition. Praha : Galén, 2006. vol. 1158. ISBN 80-7262-430-X.

Thyroid gland diseases

non - cancerous diseases	Hypothyroidism • Congenital hypothyroidism • Chronic (autoimmune) thyroiditis • Myxedema coma • Hyperthyroidism • Graves-Basedow disease • Thyrotoxicosis • Thyrotoxic crisis • Neonatal hyperthyroidism • Goiter (pediatrics) • Thyroiditis • Thyroid gland diseases

cancer illnesses	Thyroid adenoma • Toxic adenoma • Differentiated thyroid carcinoma • Anaplastic thyroid carcinoma • Medullary thyroid carcinoma

thyroid examination	Examination of thyroid function • Thyroid diseases examination

Portal: Endocrinology and metabolism