THYROID MALIGNANCYCLINICAL FEATURES
NEETHI.T.PROLL NO: 29
PAPILLARY CARCINOMA OF THYROID
CLINICAL FEATUTES• Thyroid swelling – soft or firm or hard solid or cystic solitary or multinodular
• Compression features are uncommon
• Often descrete lymphnodes in the neck (40%) are palpable
• This may present with secondaries in neck lymphnodes with occult primary
FOLLICULAR CARCINOMA
CLINICAL FEATURES
• Swelling in the neck- firm or hard and nodular
• Tracheal compression/ infiltration & stridor
• Dyspnoea, haemoptysis, chest pain when there are lung secondaries
• Hoarseness of voice if recurrent laryngeal nerve involvement occurs
• Absence of carotid pulsation, if lesion infiltrate into carotid sheath (positive berry’s sign)
• Pulsatile secondaries in skull and longbones
CLINICAL SCORING SYSTEMS
• AMES clinical scoring system
Based on Age distant Metastasis Extent of primary tumour Size of primary tumour
• AGES clinical scoring system
Based on Age pathologic Grade of the tumour Extent of the tumour Size of the tumour
Prgnostic risk classification for patientsbased on AMES or AGES
Risk
parameter LOW HIGH
age <40 >40
gender female male
extent No local extension, intrathyroidal, no capsular invasion
Capsular invasion, extrathyroidal extension
metastasis none Regional or distant
size <2 cm >4 cm
grade Well differentiated Poorly differentiated
ANAPLASTIC CARCINOMA CLINICAL FEATURES
• Swelling in thyroid region- rapidly progressive hard with involvement of isthmus and lateral
lobes• Stridor and hoarseness of voice due to
tracheal obstruction• Dysphagia• Fixity to the skin• Positive berry’s sign
MEDULLARY CARCINOMA
CLINICAL FEATURES
• Thyroid swelling often with enlargement of neck nodes
• Diarrhoea, flushing (30 %)
• Hypertension, pheochromocytoma, and mucosal neuromas when associated with MEN II syndrome
• Sporadic and familial types occur in adulthood • Cases associated with MEN II syndrome occur
in younger age group
• Paraneoplastic syndrome like cushing’s, carcinoids may be present.
THANK YOU