Malignant Tumors Of The Thyroid

There are generally four types of thyroid cancer Most thyroid cancers manifestoeren as nodes asymptomatic. Very rarely cause metastases in lymph nodes, lung or bone, the initial symptoms of small thyroid cancers. Diagnosis is usually by fine needle biopsy, but may also include other tests (Editor’s note: In Germany, recommends the German Society of Endocrinology, once to determine when thyroid nodules calcitonin as a marker of medullary thyroid carcinoma). The treatment is surgery, followed by radioiodine to destroy any remaining tissue.

There are generally four types of thyroid cancer Most thyroid cancers manifestoeren as nodes asymptomatic. Very rarely cause metastases in lymph nodes, lung or bone, the initial symptoms of small thyroid cancers. Diagnosis is usually by fine needle biopsy, but may also include other tests (Editor’s note: In Germany, recommends the German Society of Endocrinology, once to determine when thyroid nodules calcitonin as a marker of medullary thyroid carcinoma). The treatment is surgery, followed by radioiodine to destroy any remaining tissue.

(See illustration of the thyroid function.) There are generally four types of thyroid cancer Most thyroid cancers manifestoeren as nodes asymptomatic. Very rarely cause metastases in lymph nodes, lung or bone, the initial symptoms of small thyroid cancers. Diagnosis is usually by fine needle biopsy, but may also include other tests (Editor’s note: In Germany, recommends the German Society of Endocrinology, once to determine when thyroid nodules calcitonin as a marker of medullary thyroid carcinoma). The treatment is surgery, followed by radioiodine to destroy any remaining tissue. There are generally four types cardiac tissue: papillary follicular Medullary Anaplastic Papillary and follicular carcinomas are due to their histological similarity to normal thyroid tissue and their differentiated function (eg secretion of thyroglobulin.) Also called differentiated thyroid carcinoma. Except for anaplastic and metastatic medullary carcinoma is thyroid carcinomas not highly malignant tumors, and they are rarely fatal with consistent therapy. Most thyroid cancers manifestoeren as nodes asymptomatic. Very rarely cause metastases in lymph nodes, lung or bone, the initial symptoms of small thyroid cancers. Diagnosis is usually by fine needle biopsy, but may also include other tests (Editor’s note: In Germany, recommends the German Society of Endocrinology, once to determine when thyroid nodules calcitonin as a marker of medullary thyroid carcinoma). The treatment is surgery, followed by radioiodine to destroy any remaining tissue. Papillary thyroid carcinomas 80-90% of all malignant diseases of the thyroid gland are in regions with sufficient iodine supply papillary carcinomas. The ratio men: women is 3: 1. They come in up to 5% of patients in families. Most patients are between 30 and 60 years old. The cancer is often more aggressive in older patients. Many papillary carcinomas contain follicular elements. A variant is called with papillärenartigen core features non-invasive follicular thyroid tumor (formerly known as non-invasive encapsulated follicular variant of papillary thyroid carcinoma known [1]). The tumor spreads in one third of patients along the lymphatic vessels to regional lymph nodes and can metastasize to the lungs. Patients <45 years, with small, limited to the thyroid tumors have a very good prognosis. Tumors> 4 cm or tumors that have spread diffusely require a total or near-total thyroidectomy with postoperative ablation by radioiodine the remaining thyroid tissue using a sufficiently high 131I-doses to be given if the patient is hypothyroid or recombinant TSH injections. after 6-12 months, treatment can to destroy all residual tissue, be repeated. TSH-suppressive l-thyroxine doses are given after this treatment, and the determination of Serumthyreoglobulinwerten is used to detect a persistence or recurrence of the disease immediately. Neck sonography will award recurrence in the lymph nodes. Approximately 10-30% of patients, especially older patients show a persistence or recurrence of the disease. Treatment encapsulated tumors <1.5 cm, which are limited to one lobe, consists of a near total thyroidectomy, although some experts recommend only lobectomy and removal of the isthmus. Nevertheless, the surgical treatment is almost always curative. In order to prevent re-growth, thyroid hormone in thyroid-stimulating hormone (TSH) is administered -supprimierender dosage, resulting in the regression microscopically small residues of the papillary carcinoma. Reference papillary thyroid carcinomas 1. Nikiforov YE, Seethala RR, Tallini G, et al. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: A paradigm shift in order to reduce overtreatment of indolent tumors. JAMA Oncol Published online April 14, 2016. doi on: 10.1001 / jamaoncol.2016.0386. Follicular thyroid carcinoma Follicular carcinoma, including Hurthle cell tumor, causing about 10% of all malignant thyroid diseases in the United States. They are more common in elderly patients and in iodine-deficient areas. They are malignant papillary carcinomas and produce hematogenous distant metastases. Treatment requires, as with papillary carcinoma, a near-total thyroidectomy followed by radioiodine to ablate remaining thyroid tissue. Metastases speak better than in papillary carcinoma of a radioiodine. TSH-suppressive doses of lThyroxin be prescribed after the treatment. Serum thyroglobulin and ultrasound of the neck should be monitored to detect a recurrence or persistence of the disease. Medullary thyroid carcinoma medullary carcinoma cause approximately 3% of all thyroid malignancies and consist of parafollicular cells, produce calcitonin. You can sporadically (usually unilateral) occur but are often run in families and are produced by a mutation of retret calcitonin. You can sporadically (usually unilateral) occur but are often run in families and are caused by a mutation of the - causes ret proto-oncogene. The familial form may be isolated or as part of a multiple endocrine neoplasia (MEN) type 2A and 2B MEN occur. Although calcitonin can lower serum levels of calcium and phosphate, serum calcium is normal as it comes through the high calcitonin levels of receptor down-regulation. Characteristic amyloid deposits that can be stained by Congo red are also found. Metastases spread through the lymphatic vessels to cervical and mediastinal lymph nodes and occasionally in the liver, lungs and bones. Patients typically exhibit an asymptomatic node of the thyroid gland. Meanwhile, many tumors even before a palpable nodes is discovered in the routine testing of blood relatives of patients with MEN 2A or MEN 2B. Medullary carcinomas present biochemically dramatically when they are associated with an ectopic hormone or peptide production (eg. B. ACTH, vasoactive intestinal polypeptide, prostaglandin, kallikrein, serotonin). The best laboratory test is the determination of serum calcitonin, which is greatly increased. A challenge with calcium (15 mg / kg i.v. over 4 h) triggers an excessive secretion of calcitonin from (Editor's note: the challenge is in Germany, to the exclusion of a pheochromocytoma is usual with pentagastrin, for which there 2013 and delivery problems). All patients with medullary carcinoma must be genetically tested. Blood relatives of patients with mutations should also be genetically tested, and the values ??for calcitonin with and without stimulation should be collected. A total thyroidectomy is indicated even when there is no evidence for a bilobuläres action. The lymph nodes will also be removed. reveals a hyperparathyroidism, removal of hyperplastic or adenomatous parathyroid glands is required. Pheochromocytomas, when they occur, are usually bilateral. Pheochromocytoma should be identified prior to thyroidectomy and removed, because otherwise there is the risk of triggering a hypertensive crisis during thyroidectomy. The long-term survival rate is high in patients with medullary carcinoma and MEN 2A; more than two thirds of affected patients after 10 years still alive. Medullary carcinoma of sporadic type has a worse prognosis. Related elevated Calcitoninspiegeln but without palpable abnormalities should undergo a thyroidectomy because there is a higher chance of recovery at this stage still early. Some experts even recommend against surgery with relatives with normal values ??for calcitonin and after stimulation, but carriers of ret are -Protoonkogen mutation. Anaplastic thyroid cancer Anaplastic carcinoma is an undifferentiated tumor that is found in 2% of all thyroid cancers. It occurs mostly in elderly patients and somewhat more common among women. The tumor stands out with a quick, painful enlargement of the thyroid. A quick enlargement of the thyroid can also be an indication of a lymphoma, particularly if it occurs in connection with Hashimoto's thyroiditis. There is no effective treatment, and the disease usually ends within one year after diagnosis fatal. About 80% of patients die within one year of diagnosis. In a few patients with very small tumors, thyroidectomy presented, followed by radiotherapy and chemotherapy as curative out. Chemotherapy is still in the experimental stage. Radiation-induced thyroid cancer thyroid tumors develop in people whose thyroid has been exposed to high doses of radiation, which can occur as a result of nuclear explosions or accidents at nuclear reactors. The tumors can appear as early as 10 years, but the risk for 30-40 years will increase. Such tumors are usually benign, but in 10% of cases with a papillary carcinoma can be expected. The tumors often grow multicentric or diffuse. Patients after irradiation of the thyroid should annually undergo a manual examination, an ultrasound and a determination of thyroid antibodies (to rule out Hashimoto's thyroiditis. A Schilddrüsenszintigramm is unreliable in detecting affected areas. If shows a suspicious node in sonography, must a fine needle biopsy be taken. If proof of suspicious or malignant areas some endocrinologists recommend TSH-lowering doses of thyroxine to ordered. the lower [/ B Thyreotropinsekretion and thus reduce the risk of thyroid tumor thyroid function and in show the fine needle biopsy a malignant tumor, surgery is indicated. the near-total or total thyroidectomy is the treatment of choice. the operation follows a radioiodine if Residuales thyroid tissue or a residual tumor is found (as a function of G ize, histology and invasiveness).

Health Life Media Team

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