Approach to Thyroid Nodule:
- 3 Things to Consider
- Toxic Nodule --> Check TSH
- Assess for Compressive Symptoms
- Check TSH
- If low, check FT4 and T3
- Get radioactive iodide uptake scan
- If normal, look at U/S
- Thyroid U/S for Size
- Features on U/S can predict risk of malignancy
- Depending on Size --> FNA
Posted 04/19/17 10:41:14 AM by Ying Liu
Four types of Thyroid cancer: Papillary, follicular, medullary and anaplastic
- Papillary and Follicular are most common and treated similarly.
- Incidence of papillary cancer is increasing (4.8 to 14.9 per 100,000)
- Risk factors include radiation and family history
- Typically presents as a thyroid nodule noticed on exam
- Prognosis extremely affected by age with patients diagnosed between 20-45 years having the best long-term prognosis (death rarely occurring in 30 year follow-up periods)
Posted 04/19/17 10:41:34 AM by Ying Liu
- Surgery is preferred management. For tumors <1cm, lobectomy is preferred but for larger tumor total thyroidectomy may be preferred
- Most patient will need thyroid hormone to suppress TSH stimulation of tumor growth. TSH goals depend on presence of thyroglobulin antibody levels
- Radioiodine therapy (RAI) can be administered after thyroidectomy to ablate residual thyroid tissue and micrometastatic disease
- Overall prognosis is very good
Posted 04/19/17 10:41:52 AM by Ying Liu
For further reading...
Posted 04/19/17 10:43:00 AM by Ying Liu
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