Thyroid cancers
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all types of thyroid cancers that affect human body. anaplastic medullary with staging and treatment
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Approach to Thyroid nodule
1) Thyroid nodules are common findings that require evaluation to determine if they are malignant or benign.
2) Evaluation involves patient history, physical exam, laboratory tests like TSH, ultrasound of the thyroid, and fine needle aspiration biopsy of suspicious nodules.
3) Most nodules are benign but ultrasound and biopsy help determine the small percentage that require surgical removal due to cancer risk.
Papillary and follicular thyroid cancer
Papillary thyroid cancer is the most common type of thyroid cancer, accounting for 85% of cases. It is more common in females than males and often spreads to lymph nodes in the neck. Follicular thyroid cancer is the second most common type, making up around 17% of cases. Both types are generally treated with total thyroidectomy followed by radioactive iodine therapy and thyroid hormone suppression treatment. Long term surveillance of thyroid cancer involves monitoring thyroglobulin levels via blood tests and imaging scans to detect any recurrence or metastasis.
Hurthel's cell ca of the thyroid gland
This document discusses Hürthle cells and Hürthle cell carcinoma of the thyroid gland. It notes that Hürthle cells can be found in both benign and malignant thyroid conditions. Hürthle cell carcinoma accounts for 3-10% of differentiated thyroid cancers. It has a higher risk of metastasis than other differentiated thyroid cancers, with metastatic disease found in 10-20% of patients at diagnosis and 34% overall. Management of Hürthle cell carcinoma involves surgical excision followed by iodine-131 scanning and potentially radioactive iodine treatment, though the cancer has lower avidity for iodine than other differentiated thyroid cancers.
Solitary thyroid nodule
This document discusses solitary thyroid nodules (STNs), which are discrete swellings in an otherwise impalpable thyroid gland. STNs have a 10-15% risk of malignancy. They can be caused by conditions like thyroid adenomas, cysts, or carcinomas. Evaluation involves a history, exam, labs, ultrasound, scan, and FNAC. FNAC is the most useful test, but cannot always distinguish benign from malignant follicular lesions. Treatment depends on findings but may include observation, surgery, or radioiodine.
Carcinoma Of Thyroid Gland
This document provides an overview of carcinoma of the thyroid gland, including epidemiology, causes and risk factors, classification, clinical presentation, diagnosis, and management. Some key points include:
- Papillary carcinoma is the most common type, accounting for around 80% of cases.
- Risk factors include radiation exposure, family history, and chronic iodine deficiency.
- Clinical presentation varies depending on the type but commonly includes a neck mass or lymph node enlargement.
- Diagnosis involves laboratory tests, imaging like ultrasound, and fine needle aspiration biopsy.
- Treatment options include surgery, radioactive iodine therapy, chemotherapy, and radiation therapy. Surgical management depends on factors like tumor size and
Seminoma
This document summarizes information about seminoma, a type of testicular cancer. It discusses the anatomy and epidemiology of testicular tumors. It describes risk factors, pathology, pathways of spread, clinical features, diagnostic workup and staging of seminoma. It provides details about management including surgery, radiation therapy and chemotherapy for different stages. It discusses follow-up protocols and results of therapy.
Thyroid Noudle
- Thyroid nodules are very common, found in 4-7% of people on physical exam and almost 50% on ultrasound, with most people having multiple nodules. Thyroid cancer is found in 5-10% of palpable nodules.
- Factors that increase cancer risk include nodule size over 3 cm, male sex, radiation exposure, family history of thyroid cancer, and symptoms of local invasion. Features suggesting benign nodules include a family history of autoimmune disease and benign nodules.
- Evaluation involves ultrasound, thyroid function tests, and fine needle aspiration of suspicious nodules, with surgery for nodules found to be malignant or indeterminate
Soft tissue sarcoma
Soft tissue sarcomas are rare malignant tumors that can arise in any soft tissue of the body. They are characterized by their genetic alterations and histological grade. Diagnosis is made through biopsy and imaging is used to stage the tumor. Treatment typically involves complete surgical resection with negative margins, along with possible adjuvant radiation and chemotherapy depending on tumor grade and size. Prognosis depends on factors like tumor size, grade, depth, and completeness of resection. Recurrence rates remain high, especially for retroperitoneal and visceral soft tissue sarcomas.
Recommended
Approach to Thyroid nodule
1) Thyroid nodules are common findings that require evaluation to determine if they are malignant or benign.
2) Evaluation involves patient history, physical exam, laboratory tests like TSH, ultrasound of the thyroid, and fine needle aspiration biopsy of suspicious nodules.
3) Most nodules are benign but ultrasound and biopsy help determine the small percentage that require surgical removal due to cancer risk.
Papillary and follicular thyroid cancer
Papillary thyroid cancer is the most common type of thyroid cancer, accounting for 85% of cases. It is more common in females than males and often spreads to lymph nodes in the neck. Follicular thyroid cancer is the second most common type, making up around 17% of cases. Both types are generally treated with total thyroidectomy followed by radioactive iodine therapy and thyroid hormone suppression treatment. Long term surveillance of thyroid cancer involves monitoring thyroglobulin levels via blood tests and imaging scans to detect any recurrence or metastasis.
Hurthel's cell ca of the thyroid gland
This document discusses Hürthle cells and Hürthle cell carcinoma of the thyroid gland. It notes that Hürthle cells can be found in both benign and malignant thyroid conditions. Hürthle cell carcinoma accounts for 3-10% of differentiated thyroid cancers. It has a higher risk of metastasis than other differentiated thyroid cancers, with metastatic disease found in 10-20% of patients at diagnosis and 34% overall. Management of Hürthle cell carcinoma involves surgical excision followed by iodine-131 scanning and potentially radioactive iodine treatment, though the cancer has lower avidity for iodine than other differentiated thyroid cancers.
Solitary thyroid nodule
This document discusses solitary thyroid nodules (STNs), which are discrete swellings in an otherwise impalpable thyroid gland. STNs have a 10-15% risk of malignancy. They can be caused by conditions like thyroid adenomas, cysts, or carcinomas. Evaluation involves a history, exam, labs, ultrasound, scan, and FNAC. FNAC is the most useful test, but cannot always distinguish benign from malignant follicular lesions. Treatment depends on findings but may include observation, surgery, or radioiodine.
Carcinoma Of Thyroid Gland
This document provides an overview of carcinoma of the thyroid gland, including epidemiology, causes and risk factors, classification, clinical presentation, diagnosis, and management. Some key points include:
- Papillary carcinoma is the most common type, accounting for around 80% of cases.
- Risk factors include radiation exposure, family history, and chronic iodine deficiency.
- Clinical presentation varies depending on the type but commonly includes a neck mass or lymph node enlargement.
- Diagnosis involves laboratory tests, imaging like ultrasound, and fine needle aspiration biopsy.
- Treatment options include surgery, radioactive iodine therapy, chemotherapy, and radiation therapy. Surgical management depends on factors like tumor size and
Seminoma
This document summarizes information about seminoma, a type of testicular cancer. It discusses the anatomy and epidemiology of testicular tumors. It describes risk factors, pathology, pathways of spread, clinical features, diagnostic workup and staging of seminoma. It provides details about management including surgery, radiation therapy and chemotherapy for different stages. It discusses follow-up protocols and results of therapy.
Thyroid Noudle
- Thyroid nodules are very common, found in 4-7% of people on physical exam and almost 50% on ultrasound, with most people having multiple nodules. Thyroid cancer is found in 5-10% of palpable nodules.
- Factors that increase cancer risk include nodule size over 3 cm, male sex, radiation exposure, family history of thyroid cancer, and symptoms of local invasion. Features suggesting benign nodules include a family history of autoimmune disease and benign nodules.
- Evaluation involves ultrasound, thyroid function tests, and fine needle aspiration of suspicious nodules, with surgery for nodules found to be malignant or indeterminate
Soft tissue sarcoma
Soft tissue sarcomas are rare malignant tumors that can arise in any soft tissue of the body. They are characterized by their genetic alterations and histological grade. Diagnosis is made through biopsy and imaging is used to stage the tumor. Treatment typically involves complete surgical resection with negative margins, along with possible adjuvant radiation and chemotherapy depending on tumor grade and size. Prognosis depends on factors like tumor size, grade, depth, and completeness of resection. Recurrence rates remain high, especially for retroperitoneal and visceral soft tissue sarcomas.
Surgical diseases of the parathyroid gland
The document discusses surgical diseases of the parathyroid glands, including primary hyperparathyroidism, secondary hyperparathyroidism, and tertiary hyperparathyroidism. Primary hyperparathyroidism is caused by an increased production of parathyroid hormone and can be due to a single adenoma, hyperplasia, or carcinoma. It often presents with hypercalcemia, hypophosphatemia, and is typically treated with surgery to remove the affected gland(s). Secondary hyperparathyroidism is caused by chronic kidney disease or other conditions and is treated by addressing the underlying disorder. Tertiary hyperparathyroidism occurs after treatment of chronic kidney disease and may require surgery.
Differentiated thyroid carcinoma
Differentiated thyroid carcinoma, Papillary carcinoma thyroid, Follicular carcinoma thyroid, Thyroid nodule
2. classification of goitre
The document discusses the classification, clinical features, and pathophysiology of goiter. It describes the different types of goiter including simple goiter, toxic goiter, and neoplastic goiter. Simple goiter is further divided into diffuse hyperplastic goiter and nodular goiter. The natural history of simple goiter progression from diffuse hyperplasia to nodular formation is explained. Multinodular goiter and solitary thyroid nodules are also described in detail including their stages of formation, clinical presentations, and characteristics. The clinical manifestations and signs of thyrotoxicosis are outlined.
Premalignant lesions in carcinoma penis
1. Premalignant penile lesions can be divided into non-HPV related (inflammatory) and virus related categories. Non-HPV related lesions include cutaneous horn, pseudoepitheliomatous micaceous and keratotic balanitis, and male lichen sclerosus.
2. Virus related lesions include condyloma acuminata caused by HPV, Bowenoid papulosis which is associated with HPV 16, and Kaposi sarcoma caused by HHV8.
3. These premalignant lesions require treatment such as surgical excision or laser ablation to prevent progression to squamous cell carcinoma, which over 40% of penile cancer patients have a history
Marjolin's ulcers
This document provides a review of Marjolin's ulcers (MUs), which represent malignant degeneration that develops in post-burn scars and wounds. Some key points:
- MUs most commonly occur in areas of full thickness burns that healed through secondary intention, wounds that never fully healed, or unstable post-burn scars.
- The incidence of MUs in post-burn lesions is reported to be 0.77-2%. They typically present as flat, indurated ulcers or exophytic papillary growths.
- Lower limbs are the most frequent site affected. The average latency period between initial burn and MU development is 35 years, though it can range from less than
Management Of Testicular Tumours
1. Testicular cancer is most common in young men aged 20-40 years and 90-95% are germ cell tumors.
2. Survival rates have improved to over 95% for stage I and II seminomas and 90% for stage I non-seminomas due to better understanding of the disease, use of tumor markers, and cisplatin chemotherapy.
3. Treatment involves radical orchidectomy followed by radiotherapy for seminomas or lymph node dissection/chemotherapy for non-seminomas depending on stage.
CARCINOMA PENIS
1) Cancers of the penis are rare but devastating, accounting for 0.4-0.6% of cancers in men in the US and Europe but up to 10% in some other regions.
2) Risk factors include poor hygiene, phimosis, HPV infection, and lack of circumcision. Over 95% are squamous cell carcinoma.
3) Staging involves physical exam, biopsy, and imaging of lymph nodes and distant organs. Treatment may include organ-sparing surgery or penile amputation depending on size, grade, and extent of invasion.
Thyroid neoplasms
This presentation gives general overview of different types of thyroid neoplasm especially surgical management and recent advances
THYROID NEOPLASMS
This document summarizes different types of thyroid neoplasms including benign and malignant tumors. It discusses the pathology, clinical features, investigations and treatment for various thyroid cancers such as papillary carcinoma, follicular carcinoma, medullary carcinoma, and anaplastic carcinoma. Risk stratification for differentiated thyroid cancers is also mentioned. Hypothyroidism and its causes, types and treatment are briefly covered at the end.
Thyroid cancer / papillary carcinoma (Doctor Faris Alabeedi MSc, MMedSc, PgD...
Thyroid cancer / papillary carcinoma (Doctor Faris Alabeedi MSc, MMedSc, PgD...Doctor Faris Alabeedi
Papillary carcinoma is the most common type of thyroid cancer. It typically affects women aged 30-50 and has a high cure rate when detected early as tumors less than 1.5 cm. While often well-differentiated, papillary carcinoma can invade local lymph nodes and in rare cases spread to distant organs. Diagnosis involves ultrasound, biopsy, and testing for thyroid function, while treatment consists of surgery followed by radioactive iodine and medication. Prognosis is generally excellent, especially for younger patients with smaller tumors.Sino nasal malignancies
This document provides information on nasal cavity and paranasal sinus cancers. It discusses the anatomy, etiology, pathology, natural history, clinical presentation, diagnostic workup, treatment recommendations including surgery, radiotherapy, reconstruction and complications of treatment. The most common tumor is squamous cell carcinoma of the maxillary sinus in males. Treatment involves surgical resection with clear margins combined with postoperative radiotherapy to improve outcomes. Advanced techniques like endoscopy, craniofacial resection and reconstruction with flaps are used to maximize tumor removal while preserving function.
Differentiated thyroid carcinoma
The document summarizes the anatomy, physiology, histopathology, clinical features, investigations, staging, and management of thyroid gland tumors. It discusses the key points of thyroid anatomy and blood supply. The primary role is production of thyroid hormones which regulate metabolism. Benign and malignant tumors are described including papillary carcinoma which is the most common type. Clinical features, investigations like ultrasound and biopsy, TNM staging, and surgical treatment including total thyroidectomy are summarized. Post-operative management involves radioiodine therapy and thyroid hormone replacement.
Carcinoma Thyroid
This document provides information on carcinoma of the thyroid gland. It begins with epidemiological data, noting it is the most common endocrine malignancy and incidence has risen in recent decades. Risk factors include radiation exposure, family history, and iodine deficiency. Presentation is typically a painless neck mass. Evaluation involves physical exam, ultrasound, fine needle aspiration, and radioactive iodine scans. Treatment depends on cancer type but generally involves surgery and radioactive iodine therapy. Long-term monitoring of thyroid markers is important for surveillance.
Solitary Thyroid Nodule
1) Solitary thyroid nodules are common and usually detected by palpation or ultrasound. Evaluation is needed to rule out malignancy given the risk of cancer in solitary nodules.
2) Ultrasound and fine needle aspiration biopsy are important diagnostic tools, with ultrasound assessing features suggestive of malignancy and FNAB providing cytology results.
3) Treatment depends on FNAB and risk factor results, ranging from observation for benign nodules to surgery for malignant or suspicious nodules. Surgery type depends on cancer risk and includes lobectomy or total thyroidectomy.
Thyroid malignancy
This document discusses the ultrasound characteristics of various thyroid cancers and lesions. It notes that papillary carcinoma is the most common thyroid cancer, often appearing as a solid, hypoechoic nodule with punctate microcalcifications and intranodular vascularity. Anaplastic carcinoma grows rapidly with areas of necrosis. Medullary carcinoma contains echogenic foci related to amyloid and calcification. Follicular lesions cannot be distinguished as benign or malignant without biopsy. Metastases to the thyroid typically appear as a well-defined hypoechoic mass, most often in the lower pole.
Testicular Cancer
This document provides information on testicular cancer, including its incidence, histology, lymph node drainage patterns, staging classifications, workup, and management guidelines. Some key points:
- Testicular cancers constitute 1% of all cancers and germ cell tumors are the most common solid tumors in men aged 15-35.
- Lymph node drainage patterns differ for right and left testes, with retroperitoneal lymph nodes being the most common site of spread.
- Germ cell tumors are the most common type and are classified based on their histologic components.
- Staging involves the TNM classification and serum tumor marker levels. Workup includes imaging, tumor marker tests, and radical orchi
Branchial anomalies
Branchial anomalies result from improper development of the branchial apparatus during embryogenesis. They present as cysts, sinuses, or fistulas in the neck region due to failure of branchial clefts or pouches to regress normally. The definitive treatment is complete surgical excision to prevent recurrent infections while protecting important nerves like the spinal accessory and recurrent laryngeal. Second branchial cleft cysts are the most common type and manifest as neck masses anterior to the sternocleidomastoid muscle.
Management of oropharyngeal tumors
Description of anatomy, lymphatic drainage, pathway of spread, diagnosis and management of oropharyngeal tumours
Keloids
This document discusses keloids, which are non-cancerous growths that form scar tissue beyond the boundaries of the original skin injury or wound. Keloids most commonly affect individuals with darker skin and tend to run in families. While the exact causes are unknown, keloids result from an overactive inflammatory response and abnormal collagen deposition during wound healing. Common symptoms include pain, itching, and restriction of motion, as well as cosmetic concerns. Treatment involves surgical excision followed by radiation therapy within 72 hours, as this combination has shown success with a low recurrence rate. The Oncology and Cancer Center at Nairobi Hospital administers keloid treatment using radiation doses measured in Grays over one to three sessions, starting
Thyroglossal duct cysts
Thyroglossal duct cysts everything about clinical features, malignancy associated are being written....
Malignant thyroid
This document discusses malignant thyroid tumors. It begins by classifying the main types: papillary carcinoma (60%), follicular carcinoma (20%), anaplastic carcinoma (10%), and medullary carcinoma (5%). Risk factors and presentations are described. Investigations include thyroid function tests, FNAC biopsy, and imaging. Staging depends on tumor size, lymph node involvement, and presence of metastases. Well-differentiated tumors like papillary and follicular carcinoma can be treated with surgery and radioactive iodine. Medullary carcinoma is associated with genetic mutations. Anaplastic carcinoma has a poor prognosis despite aggressive treatment. Post-operative complications are also reviewed.
Clinical features of thyroid malignancy
This document summarizes the key clinical features of the main types of thyroid malignancy:
- Papillary carcinoma presents as a solitary or multinodular thyroid swelling and often palpable neck lymph nodes.
- Follicular carcinoma appears as a firm or hard nodular swelling in the neck and can cause tracheal compression or infiltration of the lungs or recurrent laryngeal nerve.
- Anaplastic carcinoma causes a rapidly progressive hard swelling in the thyroid region with potential tracheal obstruction or dysphagia.
- Medullary carcinoma presents with a thyroid swelling and enlarged neck nodes, and may cause diarrhea or flushing in association with MEN II syndrome.
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Surgical diseases of the parathyroid gland
The document discusses surgical diseases of the parathyroid glands, including primary hyperparathyroidism, secondary hyperparathyroidism, and tertiary hyperparathyroidism. Primary hyperparathyroidism is caused by an increased production of parathyroid hormone and can be due to a single adenoma, hyperplasia, or carcinoma. It often presents with hypercalcemia, hypophosphatemia, and is typically treated with surgery to remove the affected gland(s). Secondary hyperparathyroidism is caused by chronic kidney disease or other conditions and is treated by addressing the underlying disorder. Tertiary hyperparathyroidism occurs after treatment of chronic kidney disease and may require surgery.
Differentiated thyroid carcinoma
Differentiated thyroid carcinoma, Papillary carcinoma thyroid, Follicular carcinoma thyroid, Thyroid nodule
2. classification of goitre
The document discusses the classification, clinical features, and pathophysiology of goiter. It describes the different types of goiter including simple goiter, toxic goiter, and neoplastic goiter. Simple goiter is further divided into diffuse hyperplastic goiter and nodular goiter. The natural history of simple goiter progression from diffuse hyperplasia to nodular formation is explained. Multinodular goiter and solitary thyroid nodules are also described in detail including their stages of formation, clinical presentations, and characteristics. The clinical manifestations and signs of thyrotoxicosis are outlined.
Premalignant lesions in carcinoma penis
1. Premalignant penile lesions can be divided into non-HPV related (inflammatory) and virus related categories. Non-HPV related lesions include cutaneous horn, pseudoepitheliomatous micaceous and keratotic balanitis, and male lichen sclerosus.
2. Virus related lesions include condyloma acuminata caused by HPV, Bowenoid papulosis which is associated with HPV 16, and Kaposi sarcoma caused by HHV8.
3. These premalignant lesions require treatment such as surgical excision or laser ablation to prevent progression to squamous cell carcinoma, which over 40% of penile cancer patients have a history
Marjolin's ulcers
This document provides a review of Marjolin's ulcers (MUs), which represent malignant degeneration that develops in post-burn scars and wounds. Some key points:
- MUs most commonly occur in areas of full thickness burns that healed through secondary intention, wounds that never fully healed, or unstable post-burn scars.
- The incidence of MUs in post-burn lesions is reported to be 0.77-2%. They typically present as flat, indurated ulcers or exophytic papillary growths.
- Lower limbs are the most frequent site affected. The average latency period between initial burn and MU development is 35 years, though it can range from less than
Management Of Testicular Tumours
1. Testicular cancer is most common in young men aged 20-40 years and 90-95% are germ cell tumors.
2. Survival rates have improved to over 95% for stage I and II seminomas and 90% for stage I non-seminomas due to better understanding of the disease, use of tumor markers, and cisplatin chemotherapy.
3. Treatment involves radical orchidectomy followed by radiotherapy for seminomas or lymph node dissection/chemotherapy for non-seminomas depending on stage.
CARCINOMA PENIS
1) Cancers of the penis are rare but devastating, accounting for 0.4-0.6% of cancers in men in the US and Europe but up to 10% in some other regions.
2) Risk factors include poor hygiene, phimosis, HPV infection, and lack of circumcision. Over 95% are squamous cell carcinoma.
3) Staging involves physical exam, biopsy, and imaging of lymph nodes and distant organs. Treatment may include organ-sparing surgery or penile amputation depending on size, grade, and extent of invasion.
Thyroid neoplasms
This presentation gives general overview of different types of thyroid neoplasm especially surgical management and recent advances
THYROID NEOPLASMS
This document summarizes different types of thyroid neoplasms including benign and malignant tumors. It discusses the pathology, clinical features, investigations and treatment for various thyroid cancers such as papillary carcinoma, follicular carcinoma, medullary carcinoma, and anaplastic carcinoma. Risk stratification for differentiated thyroid cancers is also mentioned. Hypothyroidism and its causes, types and treatment are briefly covered at the end.
Thyroid cancer / papillary carcinoma (Doctor Faris Alabeedi MSc, MMedSc, PgD...
Thyroid cancer / papillary carcinoma (Doctor Faris Alabeedi MSc, MMedSc, PgD...Doctor Faris Alabeedi
Papillary carcinoma is the most common type of thyroid cancer. It typically affects women aged 30-50 and has a high cure rate when detected early as tumors less than 1.5 cm. While often well-differentiated, papillary carcinoma can invade local lymph nodes and in rare cases spread to distant organs. Diagnosis involves ultrasound, biopsy, and testing for thyroid function, while treatment consists of surgery followed by radioactive iodine and medication. Prognosis is generally excellent, especially for younger patients with smaller tumors.Sino nasal malignancies
This document provides information on nasal cavity and paranasal sinus cancers. It discusses the anatomy, etiology, pathology, natural history, clinical presentation, diagnostic workup, treatment recommendations including surgery, radiotherapy, reconstruction and complications of treatment. The most common tumor is squamous cell carcinoma of the maxillary sinus in males. Treatment involves surgical resection with clear margins combined with postoperative radiotherapy to improve outcomes. Advanced techniques like endoscopy, craniofacial resection and reconstruction with flaps are used to maximize tumor removal while preserving function.
Differentiated thyroid carcinoma
The document summarizes the anatomy, physiology, histopathology, clinical features, investigations, staging, and management of thyroid gland tumors. It discusses the key points of thyroid anatomy and blood supply. The primary role is production of thyroid hormones which regulate metabolism. Benign and malignant tumors are described including papillary carcinoma which is the most common type. Clinical features, investigations like ultrasound and biopsy, TNM staging, and surgical treatment including total thyroidectomy are summarized. Post-operative management involves radioiodine therapy and thyroid hormone replacement.
Carcinoma Thyroid
This document provides information on carcinoma of the thyroid gland. It begins with epidemiological data, noting it is the most common endocrine malignancy and incidence has risen in recent decades. Risk factors include radiation exposure, family history, and iodine deficiency. Presentation is typically a painless neck mass. Evaluation involves physical exam, ultrasound, fine needle aspiration, and radioactive iodine scans. Treatment depends on cancer type but generally involves surgery and radioactive iodine therapy. Long-term monitoring of thyroid markers is important for surveillance.
Solitary Thyroid Nodule
1) Solitary thyroid nodules are common and usually detected by palpation or ultrasound. Evaluation is needed to rule out malignancy given the risk of cancer in solitary nodules.
2) Ultrasound and fine needle aspiration biopsy are important diagnostic tools, with ultrasound assessing features suggestive of malignancy and FNAB providing cytology results.
3) Treatment depends on FNAB and risk factor results, ranging from observation for benign nodules to surgery for malignant or suspicious nodules. Surgery type depends on cancer risk and includes lobectomy or total thyroidectomy.
Thyroid malignancy
This document discusses the ultrasound characteristics of various thyroid cancers and lesions. It notes that papillary carcinoma is the most common thyroid cancer, often appearing as a solid, hypoechoic nodule with punctate microcalcifications and intranodular vascularity. Anaplastic carcinoma grows rapidly with areas of necrosis. Medullary carcinoma contains echogenic foci related to amyloid and calcification. Follicular lesions cannot be distinguished as benign or malignant without biopsy. Metastases to the thyroid typically appear as a well-defined hypoechoic mass, most often in the lower pole.
Testicular Cancer
This document provides information on testicular cancer, including its incidence, histology, lymph node drainage patterns, staging classifications, workup, and management guidelines. Some key points:
- Testicular cancers constitute 1% of all cancers and germ cell tumors are the most common solid tumors in men aged 15-35.
- Lymph node drainage patterns differ for right and left testes, with retroperitoneal lymph nodes being the most common site of spread.
- Germ cell tumors are the most common type and are classified based on their histologic components.
- Staging involves the TNM classification and serum tumor marker levels. Workup includes imaging, tumor marker tests, and radical orchi
Branchial anomalies
Branchial anomalies result from improper development of the branchial apparatus during embryogenesis. They present as cysts, sinuses, or fistulas in the neck region due to failure of branchial clefts or pouches to regress normally. The definitive treatment is complete surgical excision to prevent recurrent infections while protecting important nerves like the spinal accessory and recurrent laryngeal. Second branchial cleft cysts are the most common type and manifest as neck masses anterior to the sternocleidomastoid muscle.
Management of oropharyngeal tumors
Description of anatomy, lymphatic drainage, pathway of spread, diagnosis and management of oropharyngeal tumours
Keloids
This document discusses keloids, which are non-cancerous growths that form scar tissue beyond the boundaries of the original skin injury or wound. Keloids most commonly affect individuals with darker skin and tend to run in families. While the exact causes are unknown, keloids result from an overactive inflammatory response and abnormal collagen deposition during wound healing. Common symptoms include pain, itching, and restriction of motion, as well as cosmetic concerns. Treatment involves surgical excision followed by radiation therapy within 72 hours, as this combination has shown success with a low recurrence rate. The Oncology and Cancer Center at Nairobi Hospital administers keloid treatment using radiation doses measured in Grays over one to three sessions, starting
Thyroglossal duct cysts
Thyroglossal duct cysts everything about clinical features, malignancy associated are being written....
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Malignant thyroid
This document discusses malignant thyroid tumors. It begins by classifying the main types: papillary carcinoma (60%), follicular carcinoma (20%), anaplastic carcinoma (10%), and medullary carcinoma (5%). Risk factors and presentations are described. Investigations include thyroid function tests, FNAC biopsy, and imaging. Staging depends on tumor size, lymph node involvement, and presence of metastases. Well-differentiated tumors like papillary and follicular carcinoma can be treated with surgery and radioactive iodine. Medullary carcinoma is associated with genetic mutations. Anaplastic carcinoma has a poor prognosis despite aggressive treatment. Post-operative complications are also reviewed.
Clinical features of thyroid malignancy
This document summarizes the key clinical features of the main types of thyroid malignancy:
- Papillary carcinoma presents as a solitary or multinodular thyroid swelling and often palpable neck lymph nodes.
- Follicular carcinoma appears as a firm or hard nodular swelling in the neck and can cause tracheal compression or infiltration of the lungs or recurrent laryngeal nerve.
- Anaplastic carcinoma causes a rapidly progressive hard swelling in the thyroid region with potential tracheal obstruction or dysphagia.
- Medullary carcinoma presents with a thyroid swelling and enlarged neck nodes, and may cause diarrhea or flushing in association with MEN II syndrome.
Carcinoma Of Thyroid Gland
This document provides an overview of carcinoma of the thyroid gland, including epidemiology, causes and risk factors, classification, clinical presentation, diagnosis, and management. Some key points are:
- Papillary carcinoma is the most common type, accounting for around 80% of cases.
- Risk factors include radiation exposure, family history, and chronic iodine deficiency.
- Clinical presentation varies depending on the type but commonly includes a solitary thyroid nodule or enlarged cervical lymph nodes.
- Diagnosis involves laboratory tests, imaging like ultrasound, and fine needle aspiration biopsy.
- Treatment options include surgery, radioactive iodine therapy, chemotherapy, and thyroid hormone replacement therapy.
Carcinoma Thyroid presentation
This document discusses the anatomy, physiology, pathology, staging, diagnosis, and treatment of thyroid cancer. Some key points:
- The thyroid gland is located in the neck and produces thyroid hormones which regulate metabolism. Thyroid cancers are classified based on their level of differentiation.
- Diagnostic evaluation includes laboratory tests, ultrasound of the thyroid, and fine needle aspiration if a nodule is detected. Prognostic factors like histology, stage, and tumor size help determine a patient's risk level.
- Surgical treatment typically involves total thyroidectomy. Lymph node dissection may also be performed. Postoperative radioactive iodine remnant ablation is recommended for intermediate- and high-risk
Thyroid cancer ppt
A supercool powerpoint about thyroid cancer that is very hard to understand unless I am speaking to you and filling in the blanks so check out my blog and look for a related post:
http://m4tt5-b10-bl0g-2o1o.blogspot.com/
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aetiology and pathogenesis of chronic obstructive lung disease
Chronic Obstructive Pulmonary Disease
Kanishk Deep Sharma
Roll no. 50
Definition
“A disease state characterised by progressive development of airflow limitation that is not fully reversible. The airflow limitation is usually progressive and usually results from an abnormal response of lungs to noxious particles or gases”
Airflow obstruction is defined as reduced FEV1/FVC ratio (< 0.7)
RISK FACTORS
Exposure to tobacco smoke.
most significant risk factor
Pipe smokers, cigar smokers and marijuana smokers
second-hand smoke
Nicotine stimulates sympathetic system
Decreased ciliary activity & ciliary loss
Decreased oxygen carrying capacity
Cellular hyperplasia
Production of mucus
Reduction in airway diameter
Increased difficulty in clearing secretions
People with asthma who smoke
increases the risk of COPD
Occupational exposure to dusts and chemicals
Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame lungs
Age
develops slowly over years
Genetics
alpha-1-antitrypsin deficiency
certain smokers more susceptible to the disease
Infection
Aggravates COPD progression
CHRONIC BRONCHITIS
presence of cough and sputum production for at least 3 months in each of 2 consecutive years, is not necessarily associated with airflow limitation
Hyperplasia of mucus-secreting glands in trachea and bronchi
Bronchioles are clogged with mucus and pose a physical barrier to ventilation
Increase in goblet cells
Disappearance of cilia
Chronic inflammatory changes and narrowing of small airways
Altered function of alveolar macrophages causing infections
Greater resistance to airflow increases work of breathing
Hypoxemia and hypercapnia develop more frequently in chronic bronchitis than emphysema
EMPHYSEMA
Abnormal permanent enlargement of the air space distal to the terminal bronchioles accompanied by destruction of bronchioles
Small bronchioles become obstructed as result of
Mucus
Smooth muscle spasm
Inflammatory process
Collapse of bronchiolar walls
Recurrent infections causing inflammation, exudates & edema
Elastin & collagen destroyed
Bronchioles collapse
Trapped air cause hyperinflation & over distension
Alveolar wall & capillary destruction
Reduced surface area for oxygen diffusion
Compensatory tachypnea
Thank you
Me stress mm of pg student
This document discusses stress management for post-graduate medical students. It recognizes that medical training can be highly stressful and discusses common stressors students may face, including academic demands, clinical responsibilities, and expectations to excel. It describes the stages of burnout from stress arousal to exhaustion and identifies risk factors like perfectionism. The document provides tips for stress management, including maintaining balance, controlling stressors, exercising, eating well, and utilizing mental techniques such as meditation. It emphasizes preventing burnout by taking care of oneself, utilizing support systems, and seeking help if needed.
Paralytic squint
PARALYTIC SQUINT
KANISHK DEEP SHARMA
ROLL NO. 50
Uncoordinated eye movement
Angle of squint varies
Motor imbalance
ETIOLOGY
Lesion of nerve
Lesion of muscles
Lesions due to
Injury
Inflammation-syphilis, disseminated sclerosis
Vascular diseases-hemorrhage, aneurysm,arteriosclerosis
Neoplasms-brain tumor
Toxins-alcohol, lead, carbon monoxide
Degeneration-chronic nuclear ophthalmoplegia
Myasthenia gravis
SYMPTOMS
DIPLOPIA
In field of action of paralyzed muscle
Long duration- suppression of false image
Vertigo & nausea
Action required towards paralysed muscle
False projection
Binocular diplopia
Secondry deviation
Defective ocular motility
Complementary head postures
Attempt to lessen diplopia
Head tilt to avoid torsion
SEQUALAE
Weakness of paretic muscle
Overacting contralateral synergistic muscle
Inhibitory palsy of contralateral antagonist
TESTS
Record of visual acuity
Ocular motility
Perimetry
Inspection of compensatory head postures
Diplopia charting
Dark room procedure
Armstrong's glasses
4ft distance, fine linear light
Primary & other positions of gaze measured
Hess charting
Explains muscle paralysis & pathological sequlae
Field of binocular fixation
Forced duction test
MANAGEMENT
Treatment of cause
Conservative measures
Vit B complex, systemic steroids
Diplopia treatment
Occluder on affected eye
SURGERIES
Muscle weakening procedure
Recession, marginal myotomy, myectomy
Muscle strengthening procedures
Resection, tucking advancement
Changing direction of muscle action
THANK YOU
Postgraduate medical education in india 2005
An overview and a critique of PG medical education in India delivered as a key-note address at Colombo, Srilanka in 2005. Both the MCI stream and the alternate NBE stream are covered in this presentation in a transparent and unbiased manner. The weaknesses in these systems are explored and suggestions to strengthen the system are highlighted..
Using this template one can easily update the slide set to 2014 by inserting the current figures from MCI and NBE websites. This should be a handy slide-set for any educator wishing to talk on PG-Medical education.
Endocrine tumours
This document discusses various types of endocrine tumours, including those originating in the pancreas, stomach, small bowel, and lungs. It provides details on insulinomas, gastrinomas, non-functional pancreatic endocrine tumours, rare functioning tumours, and neuroendocrine tumours of the gastrointestinal tract. For each type of tumour, the document outlines characteristics such as incidence, location, clinical presentation, diagnosis, and management approaches.
S parameters
S-parameters are a useful method for representing a circuit as a "black box" whose external behavior can be predicted without knowledge of its internal contents. S-parameters are measured by sending a signal into the black box and detecting the waves that exit each port. They depend on the network, source and load impedances, and measurement frequency. Common S-parameters include S11 for the reflected signal at port 1 and S21 for the signal exiting port 2 due to a signal entering port 1.
Sampling
This document discusses sampling theory and digitizing sound. It explains:
- How sound can be represented in the time and frequency domains.
- The Nyquist-Shannon sampling theorem, which states that a signal must be sampled at least twice the highest frequency to avoid aliasing.
- Key parameters for digitizing sound like sampling frequency, bit depth, and their effects on quality and file size.
- Common digital audio standards and transmission speeds like CD, telephone, ISDN, T1, and how they relate to sampling theory.
Solitary thyroid nodule
This document summarizes different types of solitary thyroid nodules (STNs), including their clinical presentations, pathological findings, investigations, and treatment approaches. It discusses STNs that may be caused by multinodular goiter, colloid nodules, cysts, autonomous toxic nodules, various forms of thyroiditis, follicular adenomas, and malignant lesions such as papillary carcinoma, follicular carcinoma, and medullary carcinoma. For each condition, it provides details on symptoms, microscopic pathology, diagnostic testing, and surgical or medical management strategies.
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This document summarizes genetic predisposition to papillary thyroid cancer. It discusses heritability estimates for various cancers including thyroid cancer. Attempts to identify predisposing genes through linkage analysis and next generation sequencing have had limited success due to genetic heterogeneity and overdiagnosis of thyroid cancer. Genome-wide association studies have identified several loci associated with small increased risks. Whole exome sequencing of families identified a potentially pathogenic variant in the SRRM2 gene segregating with disease in one family. Overall, most heritability is likely due to many common low-penetrance variants, though rare high-penetrance mutations also exist. Gene discoveries have had modest clinical impact to date.
Malignant tumours of thyroid
The document summarizes key information about the thyroid gland and thyroid tumors:
- The thyroid is located in the neck, weighs around 25g, and has lobes connected by an isthmus. It is surrounded by capsules and has relationships to surrounding structures.
- Thyroid tumors are classified into several types including follicular, papillary, and medullary carcinomas. Papillary carcinoma is the most common type and has characteristic nuclear features.
- Follicular carcinoma is less common and is diagnosed based on evidence of invasion. Prognosis depends on tumor extent and response to treatment such as surgery and radioactive iodine.
- Accurate diagnosis relies on histopathological examination of tumor
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Men 2
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This document discusses testicular tumors, including their etiology, classification, clinical presentation, diagnosis, staging, and treatment. Some key points:
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This document discusses testicular tumours and their anatomy, etiology, classification, clinical features, diagnosis, staging, and treatment. Some key points:
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A 65-year-old male presented with 6 months of progressive generalized weakness. On examination, he had pallor, koilonychia, and a smooth bald tongue. Laboratory tests found hemoglobin of 6 gm/dL, MCV of 67 fl, MCH of 20 pg, and stool that was positive for occult blood. Colonoscopy revealed a large mass in the cecum, and the diagnosis was carcinoma of the colon. The type of anemia is likely iron deficiency anemia due to occult bleeding from the colon cancer. Further workup is needed to stage the cancer and determine next steps in treatment.
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Pathology of the Thyroid Gland
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2.Inflammation
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5.Neoplasia
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This document discusses the different types and management approaches for thyroid cancer. It covers:
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2. Diagnostic workup involves ultrasound, fine needle aspiration biopsy, and staging tests if cancer is detected. FNAB results are classified from C1 to C6 indicating likelihood of malignancy.
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This document discusses the management of medullary thyroid cancer, anaplastic thyroid cancer, and thyroid lymphoma.
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Learning objectives:
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Thyroid cancers
- 1. THYROID CANCERS KANISHK DEEP SHARMA ROLL NO. 50
- 2. CLASSIFICATION OF THYROID CANCERS FOLLICULAR DIFFERENTIATED PAPILLARY FOLLICULAR MIXED UNDIFFERENTIATED ANAPLASTIC PARAFOLLICULAR MEDULLARY NON-THYROID CELL ORIGIN MALIGNANT LYMPHOMA SARCOMA METASTATIC CARCINOMA
- 5. ANAPLASTIC CARCINOMA OF THYROID 10-15% of malignant tumors of thyroid
- 6. AETIOPATHOGENESIS • Mostly Elderly Women • May develop from nodular goitre or pre-existing well differentiated carcinoma • MACROSCOPICALLY – not encapsulated, can extend even to adjacent structures
- 7. • MICROSCOPICALLY – variable from spindle shaped, small cells to multinucleate giant cells – Characteristic mitotic areas seen • EARLY FEATURE – Local infiltration • SPREAD BY – Lymphatics – Blood stream
- 8. CLINICAL FEATURES • Thyroid gland often fixed • Poor movement on swallowing • Consistency hard to very firm • Berry’s sign positive • At time of diagnosis invasion to trachea, oesophagus or adjacent structures of neck present • Tracheal, oesophageal obstruction • Regional lymph nodes frequently enlarged • Metastasis to bones & lungs common
- 9. STAGING • All anaplastic thyroid cancers are considered stage IV
- 11. MANAGEMENT • Diagnosis is by fine needle aspiration biopsy
- 12. • If confined to thyroid(minority of patients) – Complete resection of thyroid – Strap muscles resection • ADVANCED STAGES – Tracheal obstruction • Urgent tracheal decompression • Tissue obtained for histology by isthmusectomy • Tracheostomy avoided • External Radiotherapy in all cases – Provides period for palliation
- 13. PROGNOSIS • Maximum survival of 6 months • Average survival of 3 months
- 14. FOLLICULAR DIFFERENTIATED PAPILLARY FOLLICULAR MIXED UNDIFFERENTIATED ANAPLASTIC PARAFOLLICULAR MEDULLARY NON-THYROID CELL ORIGIN MALIGNANT LYMPHOMA SARCOMA METASTATIC CARCINOMA
- 15. • A solid mass of cell : ‘medullary’ • Tumour of parafollicular C-cells • Secrete calcitonin – 32 amino acid polypeptide – Lowers serum calcium levels
- 16. ETIOPATHOGENESIS • C-cells derived from neural crest cells(part of Amine Precursor Uptake Decarboxylase cells)
- 17. • C-cells concentrated superolaterally in thyroid lobes • C-cell hyperplasia considered precursor of medullary carcinoma
- 18. U/S medullary carcinoma with calcifications
- 19. • Characteristic amyloid stroma present
- 21. • High levels of serum calcitonin & carcinoembryonic antigen produced • Diarrhea present – 30% cases – Presence of 5-hydroxytryptamine/ prostaglandin produced by tumour cells – Increased motility & impaired absorption of water & electrolyte
- 22. 1. Familial (10-20% cases) non MEN 2. MEN IIA (Sipple Syndrome) 3. MEN IIB (Wagenmann–Froboese syndrome)
- 23. MEN IIA • Affects children & young adults • Variation in RET proto-oncogene • Thyroid Medullary carcinoma with adrenal pheochromocytoma & hyperparathyroidism • pheochromocytoma – Adrenal medullary cells part of APUD cells • Due to low serum calcium levels parathyroid stimulated causing hyperplasia
- 24. MEN IIB • Thyroid medullary carcinoma with – Prominent mucosal neuroma(involve lips, tongue & inner aspects of eyelids) – Marfinoid habitus(long bones disproportionally elongated)
- 25. CLINICAL FEATURES • Neck mass • Pain referred to ear or jaw • Local invasion – dysphonia, – Dyspnea – Dysphagia
- 26. • cervical lymphadenopathy(50-60%) – Central Neck(level VI) – Superior mediastinum(level VII) • Blood born metastasis common – Liver – Bone (characteristically osteoblastic) – Lung • Diarrhea • May present with kidney stone due to hyperparathyroidism • Symptoms of pheochromocytoma
- 27. DIAGNOSIS AND SPECIAL INVESTIGATIONS • Serum calcitonin levels by radioimmunoassay • Calcitonin levels – In basal state – After stimulation test by inj. Pentagastrin i.v. bolus (0.5 mcg/Kg) – Successful in detecting early MEN cases without clinical signs or radiological evidence • Not TSH dependent therefore doesn’t take up radioactive iodine • In Familial cases genetic screening – RET gene mutation – Supplemented by serum calcitonin estimation • Dx of pheochromocytoma – 24hr urinary catecholamine, metanephrine & VMA levels confirms diagnosis • Hyperparathyroidism detected on serial measurements of blood Ca levels • Even small tumour confined to thyroid may spread by time of dx • Progression may have indolent course and long survival even without cure
- 30. TREATMENT • Total thyroidectomy due to multi-centricity with prophylactic/therapeutic resection of central & B/L cervical lymph nodes • Fall of calcitonin levels after resection & rise with recurrence, therefore, valuable tumor marker • Prophylactic surgery recommended for infants(1yr) with genetic trait of MEN
- 31. • All family members of patients should be evaluated for serum calcitonin, If high then prophylactic total thyroidectomy • Chemotherapy with adriamycin has lead to remission
- 32. • If hyperthyroidism present – Subtotal parathyroidectomy(90% gland excision) • All cases, before thyroidectomy, pheochromocytoma must be excluded • Pheochromocytoma – B/L total adrenalectomy due to multicentricity & B/L nature of lesion – Preoperatively • Phenoxybenzamine(50-200mg/day) • Propranolol(40mg/day) – Postoperatively • Long term glucocorticoid & mineralocorticoid therapy
- 33. PROGNOSIS • Varies with stage of diagnosis • Nodal involvement virtually eliminates prospects of cure • 5yr survival without lymph node metastasis is 70%