What is Endocrinology - Describe thyroid cancer's epidemiology.
One of the rare malignancies that has seen a rise in absolute incidence and mortality over the past several decades is thyroid cancer; in 2012, there were predicted to be 56,400 new cases diagnosed and 1780 fatalities. With an average 5-year survival rate of 97 percent of patients, relative survival has improved since the 1970s. An improvement in imaging has led to a large number of new thyroid cancer diagnosis. Since the late 1990s, 50% of the growth has been attributed to the discovery of tumours smaller than 1.0 cm. However, a research indicating that improved identification of incidental malignancies is not the only reason for the increasing incidence suggests that up to 20% of the rise in diagnoses are for tumours larger than 2.0 cm. Women are three times more likely to develop thyroid cancer than males, making it the seventh most frequent disease in women overall. Men tend to experience more aggressive thyroid cancer, but the fatality rates for both sexes are comparable.
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What is Endocrinology - What types of thyroid cancer are there?
Three general subtypes of thyroid cancer can be distinguished: differentiated thyroid cancer (DTC), which includes papillary thyroid cancer (PTC) and its variants, follicular thyroid cancer (FTC), and Hürthle cell carcinoma; medullary thyroid cancer (MTC); and anaplastic thyroid cancer (ATC), a type of undifferentiated thyroid cancer. . Thyroid lymphoma, mucoepidermoid carcinoma, and metastases to the thyroid gland are a few other uncommon kinds of thyroid cancer. . What is Endocrinology - What function does thyroxine-based suppression therapy serve?
Thyroxine suppression medication was previously used routinely under the assumption that it would shrink thyroid nodules, but randomised controlled studies, some of which included ultrasound measurements, have shown that it is unsuccessful. This finding implies that thyroid regression rather than the nodule itself was likely responsible for the apparent reduction in size of solitary nodules when determined only by palpation. Except in cases of iodine deficit and the prevention of new nodules following lobectomy in patients exposed to radiation, thyroid hormone is useless for euthyroid persons. These exclusions are hardly ever observed today. Routine TSH-suppressive thyroid hormone therapy for thyroid nodules or goitre is no longer recommended since it is likely to have more iatrogenic side effects than benefits. What is Endocrinology - Which thyroid disorders that cause goitre are treated with radioactive iodine?
Solitary toxic nodules, toxic nodular goitre, and diffuse toxic goitre can all be effectively treated with radioiodine. Radioactive iodine can also be used to treat benign multinodular goitres that are causing compressive symptoms in patients who are deemed to be poor surgical risks. Even if the goitre only reduces by around 30% or less, symptom alleviation is frequently seen. What is Endocrinology - Radioactive iodine or antithyroid drugs were first utilised to treat diffuse toxic goitre (Graves' disease).
The early 1940s saw the development of both techniques. Methimazole and propylthiouracil quickly took the place of the initially employed goitrogenic drug, thiourea, because of its hazardous side effects. Radioactive iodine (radioiodine), which was created during World War II, was utilised before 131I. Around 1946, radioiodine became widely accessible. What is Endocrinology - Who developed the thyroidectomy incision?
The incision was created by Swedish surgeon Theodor Kocher (1841–1917). The doctor should exercise caution while requesting a "Kocher" in the operating room because he was a pioneer. In addition, Kocher's name is connected to a wrist operation, a surgical forceps, and a right subcostal incision for cholecystectomy. What is Endocrinology - What does a heated nodule mean, exactly?
A heated nodule, however, may be cancerous. Because they are surrounded by healthy thyroid tissue, some hyperfunctional or isofunctional nodules are actually cold nodules that appear to concentrate tracer. Other autonomous nodules are unable to produce enough thyroid hormone to reduce TSH and reduce the uptake of tracers by the surrounding normal thyroid tissue. The autonomous nature of such a nodule can be determined by thyroid scanning following the administration of a TSH-suppressive dose of thyroid hormone to the patient. All other nodules require FNA to rule out thyroid cancer, while autonomous nodules can be monitored just by observation. What is Endocrinology - Describe the differences between hot and cold nodules.
A cool nodule absorbs less radioactive material than the surrounding healthy thyroid tissue. Almost all thyroid tumours on scan are cold, however the majority of cold nodules are benign. Tracer is avidly absorbed by a single toxic or heated nodule, but it is inhibited in the rest of the thyroid. Most solitary poisonous nodules are larger than 3 cm in diameter and develop in adults over the age of 40. The thyrotropin receptor gene has gain-of-function mutations in the majority of single toxic thyroid nodules. Cancer is never present in toxic adenomas. What is Endocrinology - . What happens if the TSH is discovered to be low?
The next test should be a thyroid scan to rule out toxic multinodular goitre or a single toxic nodule. Despite the expectation that lesions with autonomous function will be found during the scan, a photopenic (cold) nodule may occasionally be seen. What is Endocrinology - If the TSH is low, should a FNA be done on a palpable nodule?
No. Hyperthyroidism is indicated by a low TSH. |
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