Histology Heroes
This is the most common type of thyroid cancer.
What is papillary thyroid carcinoma?
This is the first-line imaging for thyroid nodules.
What is a neck ultrasound?
This is the age cutoff used in AJCC 8th edition thyroid cancer staging.
What is 55 years old?
Those younger than 55 can only be stage 1 or 2
Radioactive isotope used in RAI therapy.
What is iodine-131?
This is the modality used in follow-up for elevated Tg with negative ultrasound.
What is whole-body RAI scan or PET-CT?
This variant of papillary thyroid cancer is associated with a worse prognosis.
What is tall cell variant?
These are some the features seen on Ultrasound that raise the suspicion that a thyroid nodule represents a malignancy.
What are Central hypervascularity, Irregular border, Microcalcifications, Taller than wide shape, Rim calcifications with small extrusive soft tissue component, Evidence of ETE?
These are risk factors for developing thyroid cancer
What are Prior radiation (esp if < 10), MEN2A and 2B, Carney Complex, Cowden, FAP (APC gene)?
T/F RAI can be given to pregnant patients
What is false?
Name which tumors are associated with MEN syndromes
What are
MEN1 - pituitary, pancreatic, parathyroid
MEN2A - parathyroid, medullary, pheochromo
MEN2B - mucosal neuroma, Marfinoid Habitus, Medullary thyroid carcinoma, pheochromocytoma
This type of thyroid cancer arises from parafollicular C-cells.
What is Medullary Thyroid Cancer?
This diagnostic tool helps evaluate functional status of a thyroid nodule.
What is a radioactive iodine uptake scan?
T staging of a tumor invading strap muscles but confined to the thyroid gland.
What is T3B?
T4 = Includes gross extrathyroidal extension beyond the strap muscle
This is first line therapy for RAI refractory thyroid carcinoma
Sorafenib/Cabozantinib also options
Vandetinib can be used for which type of thyroid cancer
What is Medullary thyroid cancer?
This is a thyroid cancer that is undifferentiated and highly aggressive.
What is anaplastic?
This is the immunohistochemical marker elevated in medullary thyroid carcinoma
What is calcitonin?
T/F Papillary cancers that harbors a BRAF V600E mutation tend to have a more aggressive disease course
What is True?
These are treatment options for anapestic thyroid cancer?
What is
Complete resection (Try to go to Ro)
Radiation with or without chemo (no standard)
Weekly pacliaxel+ carboplatin
Weekly docetaxel + doxorubicin
Weekly pacliaxel or docetaxel with radiation
TSH suppression
Dabrafneib/tremetinb if V600E
These are side effects of RAI therapy.
What are Nasal lacrimal duct stenosis, Cytopenias, MDS/solid cancer in the future,
Fertility - men and women; women should not get it if pregnant or pregnant within 6-12 months; never to lactating mothers
Follicular carcinoma can be differentiated from a follicular adenoma by this histologic feature.
What is capsular or vascular invasion?
BRAF V600E mutation is commonly found in this thyroid cancer subtype.
What is papillary thyroid carcinoma?
These are indications to perform a thyroidectomy.
What are history of prior radiation exposure (Category 2B), Extrathyroidal extension, Poorly differentiated and differentiated high-grade carcinoma, Lateral cervical lymph node metastases or gross central neck lymph node metastases, Tumor > 4 cm in diameter, Consider for bilateral nodularity, known distant metastases
These are indications to give RAI after surgery
What are Lymph nodes N1b (Metastasis to unilateral, bilateral, or contralateral lateral neck lymph nodes (levels I, II, III, IV, or V) or retropharyngeal lymph nodes), Gross extra thyroid extension, Tumor > /= 4 cm, Postoperative unstimulated thyroglobulin > 10 ng/ml, Bulky lymph nodes,Vascular invasion?
Name two medications that target RET .
What are selpercatinib and pralsetinib?