Thyroid carcinoma is the most common malignant endocrine tumor, comprising 1.5% of all malignancies. The major sub-types are papillary carcinoma (over 85% of cases), follicular carcinoma (5-15% of cases), anaplastic carcinoma (less than 5% of cases), and medullary carcinoma (5% of cases). Papillary carcinoma is the most common type, often presenting as a slow-growing painless mass in the neck, and can be treated with total thyroidectomy followed by radioactive iodine treatment and thyroid hormone suppression therapy.

1. THYROID CARCINOMA
PBL Group: D
Mentor: Mr. Santosh Deo
(Dept. Of Physiology)

2. Objectives:
Introduction &
types
Clinical Features
Management

3. • Commonest malignant Endocrine tumor
• Comprise 1.5% of all malignancies.
• Annual Incidence is 3.7 per 100,000.
• Sex Ratio is 3:1 (Female: Male)
• Can occur at any age group. Peak incidence after
age of 30.
INTRODUCTION:

4. Major Sub-Types Of Thyroid Carcinoma:
1. Papillary Carcinoma (>85% of cases)
2. Follicular Carcinoma (5% to 15% of cases)
3. Anaplastic Carcinoma (<5% of cases)
4. Medullary Carcinoma (5% of cases)

5. Most Thyroid carcinomas are derived from
Thyroid follicular epithelium EXCEPT
Medullary Carcinoma (which is derived from
Parafollicular cells)

6. Papillary Carcinoma:
 Most common (>85%)
 Related to radiation exposure
 Female: Male ratio is 2:1
 Mean age of presentation is 25 to 50 yrs.
 Slow growing painless mass.
 Lymph node metastases- common (20% of cases.)

7. • Multifocal or solitary
• Some tumors-Encapsulated
• Others- infiltrate the
adjacent parenchyma, ill
defined margins.
• Fibrosis and Calcification
Fig: Gross of Papillary Carcinoma
• Solid or Cystic

8. Histopathology- Papillae with fibrovascular stalk.

9. Optically clear appearance of Nucleus; imparting Optically Clear or
“Orphan Annie eye Nuclei”.

10. Concentrically calcified structures: Psammoma Bodies are Often
present, usually within the core of Papillae.

11. Clinical Course:
 Mostly asymptomatic thyroid nodules
 Mass in cervical lymph node
 Nodule moves freely during swallowing
 Hoarseness, Dysphagia, Cough.
 Haematogenous metastasis in the lung

12. Diagnostic tests:
Radionuclide Scanning
Shows cold masses on Scintiscan.
FNAC and Biopsy: Gold
standard

13. FNAC is the diagnostic choice

14. Prognosis:
• Excellent
• 10-year survival rate (95%)
• Depends on: -Age
-Extrathyroidal Extension
-Distant metastases

15. Management
• Total Thyroidectomy
• Ablation of remaining thyroid tissue with 131 iodine
• Long term treatment: Thyroxine to suppress TSH
• Follow up- Measurement of serum thyroglobulin

16. Summary:
 TYPES
 PAPILLARY CARCINOMA
 MANAGEMENT

17. References:
 Robbins & Cotran Pathologic Basis of Disease.
 Davidson’s Principles & Practice of Medicine.

18. THANK YOU