Thyroid Cancer Treatment

Thyroid Cancer Treatment

Describe the classification, clinical features, and management of thyroid neoplasia.
Or
Write about clinical features of papillary and follicular carcinoma of thyroid and management

Answer.

Classification of Thyroid Neoplasia

Benign

• Follicular adenoma—Colloid, embryonal, fetal
• Hurthle cell adenoma
• Colloid adenoma
• Papillary adenoma.

Malignant (Dunhill classifiation)

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Diffrentiated:

• Papillary carcinoma
• Follicular carcinoma
• Papillo-follicular carcinoma behaves like papillary carcinoma of thyroid
• Hurthle cell carcinoma behaves like follicular carcinoma.

Undifferentiated:

• Anaplastic carcinoma

Medullary carcinoma

Malignant lymphoma

Secondaries in thyroid from colon, kidney, melanoma and breast.

Clinical Features and Management of thyroid neoplasias

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Thyroid Cancer Treatment

Describe the classification, clinical features, treatment, and complications of thyroid malignancy.

Answer. Classification of thyroid malignancy Or Dunhill

Classification

• Differentiated (80%)
  Papillary carcinoma (60%)
  Follicular carcinoma (17%)
  Papillo-follicular carcinoma
  Hurthle cell carcinoma.
• Undifferentiated—20%
  Anaplastic carcinoma (13%).
• Medullary carcinoma (6%)
• Malignant lymphoma (4%)
• Secondaries in thyroid—from colon, kidney,melanoma, breast.

Clinical Features and treatment of thyroid Malignancy

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Complications of thyroid Malignancy

Complications of thyroid malignancy are associated with the thyroidectomy procedure followed as surgical treatment in most of thyroid malignancies.
So following are the complications:

Hemorrhage

• Chances of reactionary hemorrhage are present which is more dangerous and occurs within 6 to 8 hours after surgery.
  It occurs due to slipping of ligatures, coughing, etc.
• Tension hematoma develop deep-to-deep fascia it com presses the larynx.

Respiratory Obstruction

It occur due to hematoma or laryngeal edema, due to tracheomalacia or bilateral recurrent laryngeal nerve palsy.

Recurrent Laryngeal Nerve Palsy

It can be transient or permanent. Transient recover in 3 weeks to 3 months. It presents with hoarseness of voice, aphonia, aspiration and ineffctive cough.

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Hypoparathyroidism

It is temporary and due to vascular spasm of parathyroid glands. It occurson 2nd and 5thpost-operative day. It presents with weakness,positive Chvostek’s sign, carpopedal spasm, and convulsion.

Thyrotoxic Crisis

It occurs in thyrotoxic patient which is inadequately prepared for thyroidectomy.

Injury to external laryngeal nerve

It leads to weakening of cricothyroid muscle which causes alteration in pitch of voice, voice fatigue, breathy voice, and frequent throat clearing.

Hypothyroidism

It reveals clinically after 6 months.

Stitch Granuloma

It can occur with or without sinus formation and is seen after the use of non-absorbable suture material.