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35 - Thyroid

Published online by Cambridge University Press:  23 December 2009

By
Laura Moss
Edited by
Louise Hanna ,
Tom Crosby  and
Fergus Macbeth
Laura Moss
Affiliation:
Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Louise Hanna
Affiliation:
Velindre Hospital, Cardiff
Tom Crosby
Affiliation:
Velindre Hospital, Cardiff
Fergus Macbeth
Affiliation:
Velindre Hospital, Cardiff
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Summary

Introduction

Thyroid cancer consists of a diverse group of tumours with different clinical features and prognoses. Thyroid cancer can occur at any age, but it is rare in patients under the age of 25. Radiation exposure is the best-documented risk factor. Most thyroid cancers are carcinomas: these are papillary, follicular, medullary, and anaplastic, in order of frequency. Thyroid lymphomas and sarcomas are rarer. The overall prognosis is related to histological type; well-differentiated thyroid cancer (papillary and follicular) has the best prognosis. In contrast, anaplastic carcinoma progresses rapidly and has a very poor prognosis. There is a lack of evidence from prospective randomised controlled studies because differentiated thyroid cancer is an uncommon disease with a long natural history. Many areas of thyroid cancer management remain controversial, including the extent of surgery and the indications for radioiodine ablation and radiotherapy. Evidence-based guidelines published in 2002 relied on large retrospective and cohort studies (British Thyroid Association, 2002).

This chapter focuses mainly on differentiated thyroid cancer, with shorter sections on medullary thyroid carcinoma (MTC), anaplastic thyroid cancer and thyroid lymphoma.

Types of thyroid tumour

Thyroid tumours can be divided into benign, malignant primary and malignant secondary. Types of thyroid tumour are shown in Table 35.1.

The relative proportions of patients with differentiated thyroid cancer in a geographic area depend on dietary iodine intake. The proportion of follicular cancers increases where there is dietary iodine deficiency.

Type
Chapter
Information
Practical Clinical Oncology , pp. 406 - 417
Publisher: Cambridge University Press
Print publication year: 2008

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References

Administration of Radioactive Substances Advisory Committee. (2006). Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. Chilton: NRPB.
British Thyroid Association. (2002). Guidelines for the Management of Thyroid Cancer in Adults. London: Royal College of Physicians (2nd edition due 2007).
Intercollegiate Standing Committee on Nuclear Medicine. (2003). Positron Emission Tomography. A Strategy for Provision in the United Kingdom. London: Royal College of Physicians.
Mazzaferri, E., Robbins, R., Spencer, C.et al. (2003). A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. J. Clin. Endocrinol. Metab., 88, 1433–41.CrossRefGoogle ScholarPubMed
Santini, F., Bottici, V., Elisei, R.et al. (2002). Cytotoxic effects of carboplatinum and epirubicin in the setting of elevated serum thyrotropin for advanced poorly differentiated thyroid cancer. J. Clin. Endocrinol. Metab., 87, 4160–5.CrossRefGoogle ScholarPubMed
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  • Thyroid
    • By Laura Moss, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.036
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Thyroid
    • By Laura Moss, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.036
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Thyroid
    • By Laura Moss, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.036
Available formats
×