Papillary and follicular thyroid cancers are the most common types of thyroid cancer. Papillary cancer often presents as a small occult tumor and spreads via lymphatics, while follicular cancer presents as a growing nodule and spreads hematogenously to the skull. Diagnosis involves ultrasound, biopsy, and scans. Treatment consists of surgery to remove all or part of the thyroid followed by radioactive iodine and thyroid hormone therapy. Medullary cancer does not take up iodine and surgery is the main treatment. Anaplastic cancer is very aggressive and usually fatal within 6 months.
Last update of thyroid cancer management from diagnosis till follow up
You can request other lectures by emailing me at salahmab76@yahoo.com or calling me 0020 100 408 1234
Dr Salah Mabrouk Khallaf
Carcinoma Larynx; Evidence based management
Staging - Surgery - Adjuvant therapy - Organ Preservation - Altered fractionation, chemotherapy - Radiotherapy (RT) techniques, Role of IMRT
Last update of thyroid cancer management from diagnosis till follow up
You can request other lectures by emailing me at salahmab76@yahoo.com or calling me 0020 100 408 1234
Dr Salah Mabrouk Khallaf
Carcinoma Larynx; Evidence based management
Staging - Surgery - Adjuvant therapy - Organ Preservation - Altered fractionation, chemotherapy - Radiotherapy (RT) techniques, Role of IMRT
THYROID CANCER priya mam.pptx
My teacher notes respected Priya mam
Bsc 2nd year
Medical surgical nursing 1th 2nd year
MGM college of nursing
Upload:- sawan Singh (Shravan Kumar)
The Thryoid cancer baare main notes hai ye
The Thryoid cancer is of the thyroid, the butterfly-shaped gland at the base of the neck.
The cause of thyroid cancer is poorly understood, but may involve a combination of genetic and environmental factors.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
This pdf is about the Schizophrenia.
For more details visit on YouTube; @SELF-EXPLANATORY;
https://www.youtube.com/channel/UCAiarMZDNhe1A3Rnpr_WkzA/videos
Thanks...!
Earliest Galaxies in the JADES Origins Field: Luminosity Function and Cosmic ...Sérgio Sacani
We characterize the earliest galaxy population in the JADES Origins Field (JOF), the deepest
imaging field observed with JWST. We make use of the ancillary Hubble optical images (5 filters
spanning 0.4−0.9µm) and novel JWST images with 14 filters spanning 0.8−5µm, including 7 mediumband filters, and reaching total exposure times of up to 46 hours per filter. We combine all our data
at > 2.3µm to construct an ultradeep image, reaching as deep as ≈ 31.4 AB mag in the stack and
30.3-31.0 AB mag (5σ, r = 0.1” circular aperture) in individual filters. We measure photometric
redshifts and use robust selection criteria to identify a sample of eight galaxy candidates at redshifts
z = 11.5 − 15. These objects show compact half-light radii of R1/2 ∼ 50 − 200pc, stellar masses of
M⋆ ∼ 107−108M⊙, and star-formation rates of SFR ∼ 0.1−1 M⊙ yr−1
. Our search finds no candidates
at 15 < z < 20, placing upper limits at these redshifts. We develop a forward modeling approach to
infer the properties of the evolving luminosity function without binning in redshift or luminosity that
marginalizes over the photometric redshift uncertainty of our candidate galaxies and incorporates the
impact of non-detections. We find a z = 12 luminosity function in good agreement with prior results,
and that the luminosity function normalization and UV luminosity density decline by a factor of ∼ 2.5
from z = 12 to z = 14. We discuss the possible implications of our results in the context of theoretical
models for evolution of the dark matter halo mass function.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
5. THE CAUSES:
Radiation exposure to thyroid gland in
child hood
Family history : a 4 to 10 fold increased
risk of well differentiated thyroid
cancer in 1st degree relatives with this
neoplasia
6. THE CAUSES:
Iodine: Iodine-deficient diets may
lead to increase the TSH level and
considered goitrogenic
Thyroiditis: (Hashimoto's Disease)
may develop into a form of cancer
called lymphoma.
8. EVALUATION OF THYROID TUMOR:
History:
Age and Gender
Rapid increase in size, dyspnea,
dysphagia and hoarseness of voice
Family History Of thyroid cancer
History Of irradiation
On Examination:
Firmness, Mobility, Size and adherence
to surrounding structures
Presence of lymphadenopathy
12. INVESTIGATIONS:
Radionuclide Scan:
To determine the functional status of the
nodule
Hypofunctional “cold nodule”ule”
Serum Calcitonin level:
Routine measurement of calcitonin level
advocated by some authors to Diagnose
Medullary cancer is unknown
13. PAPILLARY THYROID CANCER:
Cystic or Solid
Slow growing
Young females
Female: Male is 3:1
Most common (80-85%)
Local recurrence rate of papillary carcinoma is
more while distant metastasis is less
Spread through lymphatic
Multicentric-local recurrence rate of pappilary
carcinoma is more while distant metastasis is rare.
Hugely non encapsulated
14. Most common risk factors :
Radiation
Family history
FAP
Iodine excess
Presentations:
Nodule in thyroid
Dysphagia
Dysphonia
Lymphnode enlargement
16. Orphan annie nuclei: large amount of chromatin
present in nucleus makes it transparent
17. PSAMMOMA BODIES
Psammoma bodies (PBs) are concentric
lamellated calcified structures, observed most
commonly in papillary thyroid carcinoma (PTC),
meningioma, and papillaryserous
cystadenocarcinoma of ovary but have rarely
been reported in other neoplasms and
nonneoplastic lesions.
18.
19. CLINICAL PRESENTATION:
Incidental
as a small occult tumor <1cm (papillary microcarcinoma)
Mass in the Neck
the commonest way papillary cancer presents
Glands in the Side of the Neck
The spread to local glands (sometimes called
erroneously "lateral aberrant thyroid").
Distant Spread
Spread to lungs or bone is seen but when it occurs
unlike most other cancers, cure is possible.
21. THE FOLLICULAR CANCER:
It is unifocal(local recurrence is less)
thickly encapsulated and shows
invasion of both capsule and blood
vessels
Spread by the blood stream and
rarely through lymphatic
It is unusual tumor (5 -10%)
22. RISK FACTORS:
iodine deficiency
Family history
radiation
PRESENTATION:
Already existing swelling growing in size
Nodules
Dysphagia
Dysphonia
MOST COMMON HEMATOGENEOUS SPREAD
IS TO SKULL (USUALLY TO
OCCIPUT)CAUSING PULSATILE
SECONDARIES.
23. CLINICAL PRESENTATION:
As a single lump in the thyroid:
This is the common mode of presentation.
As pain in a bone or a spontaneous fracture:
in case of metastases to bone through the
blood stream
24.
25. COMPARISON:
Non capsulated
Multicentric
Slow-growing
Iodine excess
Usually lymphatic route
of spread
Distant metastasis to
lung
Encapsulated
Unifocal
Present as rapid
increase in size
Iodine deficiency
Usually hematogenous
route of spread
Distant metastasis to
occiput
Papillary Follicular
26.
27. THE PROGNOSIS IN DIFFERENTIATED
THYROID CARCINOMA:
The two dominant factors are the age at the
diagnosis and the presence of distant
metastases.
Recent several scoring systems based on
multifactorial analysis of risk factors have been
advise
30. Low risk High risk
Patient age < 45 y > 45 y
Tumor size < 4.0 cm > 4.0 cm
Extrathyoidal
extension
absent present
Distant
metastases
absent present
High tumor
grade
absent present
32. THE TREATMENT OF WELL
DIFFERENTIATED THYROID CANCER:
It Consists of a three- pronged attack :
Thyroid Surgery
Radioactive iodine therapy
Drug - Thyroxine therapy
33. SURGERY:
Acceptable surgical procedure to remove
thyroid tumor include
Ipsilateral lobectomy
Near total thyroidectomy
Total thyroidectomy
The recent American Thyroid Association
Guide lines recommended for more aggressive
(total thyroidectomy ) for well differentiated
thyroid carcinonoma
34. USUALLY WE FOLLOW
For Papillary Thyroid Carcinoma
microinvasive –Total thyroidectomy >near total
invasive - Total thyroidectomy
o For Follicular Thyroid Carcinoma
microinvasive –hemithyroidectomy
invasive - Total thyroidectomy
If lymphnodes are involved
ipsilateral modified radical neck
dissection is done.
35.
36. SURGERY :
With a 20-year follow up the incidence of
local recurrence with unilateral resection was
(14%),whereas, for bilateral resection it was
(2%)
For gross involvement of trachea or
esophagus resection of these structures with
reconstruction
37. ONE OF THE FEATURE OF PAPILLARY THYROID
CARCINOMA IS CYST
In case of cyst-aspiration is done
simple /benign
3 times re-aspired
If it still recurs then excision is done
38. RADIOIODINE THERAPY:
The Indications:
1.After Surgery to destroy any residual thyroid
cancer cells or residual normal thyroid tissue.
2.To treat thyroid cancer that has spread to
the lymph nodes, lungs or bones.
3.To treat thyroid cancer recurrence after
initial treatment by surgery or previous
radioactive iodine or both.
39. RADIOIODINE THERAPY:
Recent American thyroid association guide
lines recommended radioiodine ablation for:
Pt. with stage III or IV disease
All Pt. with stage II disease <45 yrs or
> 45 yrs
Selected Pt. with stage I disease those
with:
large tumor ( >1.5 cm )
multifocality
residual disease
nodal metastasis
40. THYROXIN THERAPY :
Recent meta-analysis supported the
efficacy of TSH suppression in
preventing adverse clinical effect
High risk pt. are maintained at TSH level
below 0.1 mU/ L
Low risk pt. TSH level at or below the
normal range (0.1- 0.5 mU/ L)
41. THYROXIN THERAPY :
The degree of thyroid suppression is
dictated by balancing the risk of
recurrent thyroid cancer and
subclinical thyrotoxicosis
particularly the cardiovascular risks
Supression therapy is monitored by
serum thyroglobulin(ideally should
be <2ng/ml)
42. MEDULLARY THYROID CANCER:
These are tumors of parafollicular (C
cells), which produce a hormone called
calcitonin
Types of MTC :
Sporadic MTC(common type)
Familial MTC
MEN 2A
MEN 2B
Familial Non- MEN
43.
44. So a patient with Medullary Thyroid
Carcinoma, rule out MEN Syndrome
by ruling out
PHEOCHROMOCYTOMA.
In MEN- pheochromocytoma is
treated first even if it is benign
45. CLINCAL PRESENTATION:
Sporadic MTC:
asymptomatic thyroid mass that is
patient usually presents with a nodule.
Familial MTC :
patient may usually present with
diarrohea.
screening stimulation test for calcitonin
or with molecular analysis ( detection
of RET gene mutation)
46. ENZYMES SECRETED IN MEDULLARY THYROID
CARCINOMA
Calcitonin
CEA
ACTH
PROSTAGLANDINS
SEROTONIN(release is the
reason for diarrohhea)
47. TREATMENT OF SPORADIC MTC:
C cells do not concentrate
iodine so radioactive iodine is of
no value in the management
48. Surgery is the only definitive
therapy of MTC:
-Total thyroidectomy
-Central node dissection
- Ipsilateral modified radical neck
dissection
1. if size of medullary thyroid
carcinoma is more than 2 cm.
2. if LN are enlarged.
50. TREATMENT OF FAMILIAL MTC:
Based on the genetic test for the
mutation of RET gene
Since different mutations in the
RET gene are associated with
variable disease aggressiveness
this leading to individualized
treatment of pt. with inherited MTC
51. MEN2A AND FMTC RX. :
Prophylactic thyroidectomy at age 5 to
6 years
53. ANAPLASTIC CANCER OF THE THYROID:
It is a very aggressive tumor with a worst
prognosis
A female to male ratio 1.5:1 and a mean age
is 67 years
It is commonest in areas of endemic goiter
where there is chronic iodine deficiency.
ATC commonly related to prior diagnosis of
well differentiated thyroid cancer
54. CLINICAL PRESENTATION:
a long-standing goiter that suddenly
increases in size.
Local invasion lead to obstructive
symptoms, hemoptysis, dysphagia and
hoarseness
At the time of Diagnosis 25 to 50 % of
Patient have synchronous pulmonary
metastases
56. A CT scan showing anaplastic
cancer of the thyroid
A woman with anaplastic
cancer of the thyroid
57. SURGICAL TREATMENT OF ATC:
In the majority of cases surgery is
limited to an open biopsy to exclude
lymphoma
Otherwise treatment usually involves
total thyroidectomy with chemotherapy
agents
Or we can go for palliative treatment
like istemectomy or tracheostomy
58. RADIOTHERAPY AND CHEMOTHERAP:
External beam radiotherapy (EBRR) as
been used with limited success to
treat locally recurrent ATC
Doxorubicin is the single most
effective chemotherapeutic for ATC
59. THYROID LYMPHOMA:
Thyroid lymphoma is relatively rare
disease constituting <1% of all
lymphoma and accounting for 2% of
extranodal non- Hodgkin’s lymphoma
Female: Male ratio from 3:1 up to 8:1
Median age is seventh decade of life
60. CLINICAL PRESENTATION:
Local invasion : hoarseness, dyspnea
with stridor, or dysphagia
Hypothyroidism in case of Autoimmune
thyroiditis or Hashimoto’s thyroiditis
61. A 70 Y. old lady with diffuse
large B cell lymphoma
62. TREATMENT :
Primary treatment should be EBRT
combined with Chemotherapy
regimen based on histopathological
subtype of lymphoma
63. TREATMENT :
Primary treatment should be EBRT
combined with Chemotherapy
regimen based on histopathological
subtype of lymphoma
Green LD et al, anaplastic thyroid
cancer and 1ry thyroid lymphoma. J
Surg Oncol 2006;94:725