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Health Library : Endocrinology

 

Thyroid Tumors

Did you know?

A nodule found in a man's thyroid is more likely to be cancer than when found in a woman.

What is radioactive iodine treatment?

The thyroid needs iodine to properly produce the thyroid hormones. By administering radioactive iodine to a patient, the thyroid tissue will absorb the altered iodine, which then destroys that thyroid tissue.

What are thyroid tumors?

The thyroid gland is located in the front of the neck at the base of the throat. Thyroid tumors are either benign (noncancerous) or malignant (cancerous) growths. Examples of benign tumors are adenomas, which secrete thyroid hormone. Malignant tumors are more rare and are more common in women than in men. According to the American Cancer Society (ACS), over 56,000cases of thyroid cancer were expected to be diagnosed in the US in 2012.

What are thyroid adenomas?

Thyroid adenomas are small growths (nodules) that start in the cell layer that lines the inner surface of the thyroid gland. The adenoma itself secretes thyroid hormone. If the adenoma secretes enough thyroid hormone, it may cause hyperthyroidism. Thyroid adenomas may be treated if they cause hyperthyroidism. Treatment may include surgery to remove part of the thyroid (the overactive nodule).

What are cancerous thyroid tumors?

Cancer of the thyroid occurs more often in people who have undergone radiation to the head, neck, or chest. However, it may occur in people without any know risk factors. Most thyroid cancer can be cured with appropriate treatment. Thyroid cancer usually appears as nodules within the thyroid gland. Some signs that a nodule may be cancerous include:

  • Presence of a single nodule rather than multiple nodules
  • Thyroid scan reveals the nodule is not functioning
  • Nodule is solid instead of filled with fluid (cyst)
  • Nodule is hard
  • Nodule grows fast

What are the symptoms of thyroid cancer?

The first sign of a cancerous nodule in the thyroid gland is usually a painless lump in the neck.

However, each individual may experience symptoms differently. Other symptoms may include:

  • Hoarseness or loss of voice as the cancer presses on the nerves to the voice box
  • Difficulty swallowing as the cancer presses on the throat
  • Throat or neck pain that does not go away
  • Breathing problems
  • A cough that does not go away

However, the symptoms of thyroid cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Diagnosis of thyroid cancer:

In addition to a complete medical history and medical examination, diagnostic procedures for thyroid cancer may include:

  • Thyroid scan
  • Ultrasound
  • Biopsy - taking a sample of the nodule with a needle for examination under a microscope

Thyroid cancer comes in four main forms:

Papillary thyroid cancer Papillary thyroid cancer is the most common form of thyroid cancer, accounting for about 80 percent of all cases. This form of thyroid cancer affects more women than men.

Treatment for papillary cancer may include:

  • Surgery - to remove part or all of the thyroid (called a thyroidectomy) and sometimes nearby lymph nodes
  • Thyroid hormone therapy - to suppress the pituitary gland from secreting more thyroid-stimulating hormone, which may stimulate a recurrence of papillary cancer
  • Administration of radioactive iodine - to destroy any remaining thyroid tissue
Follicular thyroid cancer Follicular thyroid cancer occurs most often among individuals between 20 and 60 years of age and accounts for about 10 percent of thyroid cancer cases. This type of thyroid cancer is more aggressive and tends to spread through the bloodstream to other parts of the body. Still, the prognosis (outlook) is very good in most cases.

Treatment for follicular cancer may include:

  • Surgery - to remove the thyroid gland (thyroidectomy) and sometimes nearby lymph nodes
  • Thyroid hormone therapy
  • Administration of radioactive iodine - to destroy any remaining thyroid tissue
Anaplastic thyroid cancer Anaplastic thyroid cancer tends to occur most often among women and accounts for about 2 percent of thyroid cancer cases. This quick-growing cancer usually results in a large growth in the neck. It has often spread to other parts of the body by the time it is found and is very hard to treat effectively.

Treatment for anaplastic thyroid cancer may include:

  • Surgery - to remove the thyroid gland (thyroidectomy) if it has not spread extensively, although this is rare
  • Chemotherapy (i.e., anticancer drugs)
  • Radiation therapy
Medullary thyroid cancer

Medullary thyroid cancer tends to spread through the lymphatic system (which consists of a system of vessels that connect lymph nodes throughout the body) and the bloodstream to other parts of the body. This type of cancer produces excessive amounts of calcitonin, a hormone also produced by the thyroid gland itself.

Treatment for medullary thyroid cancer may include:

  • Surgery - to remove the thyroid gland (thyroidectomy) and sometimes nearby lymph nodes
  • Radiation therapy
  • Targeted therapy drugs, such as vandetanib

Additional surgery may be necessary if the cancer has spread.

Because medullary cancer tends to run in families, screening tests for genetic abnormalities in the blood cells may be conducted.

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