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Clinical features of thyroid malignancy


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Clinical features of thyroid malignancy

  2. 2. 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
  3. 3. 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
  4. 4. • 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
  5. 5. CLINICAL SCORING SYSTEMS • AMES clinical scoring system Based on Age distant Metastasis Extent of primary tumour Size of primary tumour
  6. 6. • AGES clinical scoring system Based on Age pathologic Grade of the tumour Extent of the tumour Size of the tumour
  7. 7. Prgnostic risk classification for patients based 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
  8. 8. 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
  9. 9. 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
  10. 10. • 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.
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