Thyroid Cancer

A rare form of cancer and is cancer of the thyroid gland that can be mistaken for goitre (non-cancerous nodules and swellings on thyroid gland) in hyperthyroidism or hypothyroidism.

• It tends to affect women more than men; less aggressive forms occur mainly to persons under 40 years old and thus are more treatable (papillary carcinoma).
• More aggressive forms occur to persons between 60-80 years old (anaplastic thyroid carcinoma).

Thyroid Gland

The thyroid is a butterfly-shaped gland at the base of your neck that makes hormones that help regulate your blood pressure, temperature, heart rate, and weight.

The four main types of thyroid cancer, including:

• Papillary or mixed papillary-follicular thyroid cancer (solid, irregular or cystic mass over thyroid tissue)
• Follicular or Hurthle cell thyroid cancer
• Medullary thyroid cancer
• Anaplastic thyroid cancer
• Thyroid lymphoma
• Thyroid sarcoma

• Thyroid carcinoma most commonly manifests as a painless, palpable, solitary thyroid nodule.
• Patients or physicians discover most of these nodules during routine palpation of the neck.
• Most palpable thyroid nodules represent benign disease.
• Palpable and nonpalpable nodules of similar size have the same risk for malignancy.

Medscape

Diagnose Tests

• Fine-needle aspiration biopsy (FNAB)
• Neck ultrasonography
• Thyroid radioiodine imaging
• Neck computed tomography (CT) scanning
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET) scanning (assess recurrent disease)
• Laboratory studies
  • Serum thyroid-stimulating hormone (TSH) concentration.
  • Serum calcitonin/pentagastrin-stimulated calcitonin levels: Elevated levels are highly suggestive of medullary thyroid carcinoma; these measurements may also be used for posttreatment monitoring of recurrent disease.
  • Polymerase chain reaction (PCR) assay for germline mutations in the RET proto-oncogene may aid in the diagnosis of FMTC, as well as MEN 2 syndromes.
  • Serum thyroglobulin levels (postoperative): Elevated levels are a strong indicator of tumor recurrence in patients with differentiated thyroid cancer; these findings are most sensitive in the presence of hypothyroidism and elevated TSH levels. For long-term monitoring, measurements of thyroglobulin and antithyroglobulin antibodies should be obtained.
  • Molecular diagnostic testing: May be used for detection/identification of specific genetic mutations, such as RET/PTC and BRAF V600E, among others. These mutations may occur in papillary and/or follicular tumors.
  • Molecular pattern recognition studies with molecular classifiers may help to guide treatment decisions when FNA biopsy findings are indeterminate.

National Cancer Institute. Thyroid cancer treatment (PDQ)– Health Professional Version: General information about thyroid cancer

American Cancer Society. Thyroid cancer.

Sharma PK, Johns MM, Anderson KM. Thyroid cancer. Medscape Drugs & Diseases. Updated July 19, 2024

Callejas L, Ahn P, Holsinger FC, Hu MI. Thyroid and parathyroid cancers. Cancer Network

National Comprehensive Cancer Network (NCCN). Clinical practice guidelines in oncology (NCCN guidelines): Thyroid carcinoma. Version 3.2024 – June 18, 2024.

• Blood tests
• Biopsy