Pearls from Dr. Susana Ebner
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
Created by Christopher Kelly
Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.