Papillary thyroid cancer

Papillary thyroid cancer
Cytopathology of papillary thyroid carcinoma.png
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Lump in the neck, difficulty swallowing, hoarseness
Complications	Metastasis, recurrence
Onset	Middle-aged adults
Duration	N/A
Types	Classic, follicular variant, tall cell variant
Causes	Genetic mutations, radiation exposure
Risks	N/A
Diagnosis	Ultrasound, fine needle aspiration biopsy
Differential diagnosis	N/A
Prevention	N/A
Treatment	Surgery, radioactive iodine, thyroid hormone therapy
Medication	N/A
Prognosis	Generally good with treatment
Frequency	N/A
Deaths	N/A

Papillary thyroid cancer (PTC) is the most common type of thyroid cancer, accounting for approximately 80% of all thyroid cancer cases. It arises from the follicular cells of the thyroid gland and is characterized by its distinctive papillary architecture.

Epidemiology

Papillary thyroid cancer is more prevalent in women than in men and typically presents in middle-aged adults. It is the most common thyroid cancer in children and young adults.

Pathophysiology

Papillary thyroid cancer originates from the follicular cells of the thyroid gland. It is often associated with genetic mutations such as BRAF and RET/PTC rearrangements. Exposure to ionizing radiation, especially during childhood, is a well-known risk factor.

Clinical Presentation

Patients with papillary thyroid cancer may present with a palpable nodule in the neck, difficulty swallowing, or hoarseness. However, many cases are asymptomatic and are discovered incidentally during imaging for other reasons.

Diagnosis

The diagnosis of papillary thyroid cancer is typically made through a combination of:

• Ultrasound: To evaluate the thyroid nodule's characteristics.
• Fine needle aspiration biopsy: To obtain cytological samples for analysis.

Gross appearance of papillary carcinoma of the thyroid gland

Histopathology

Histologically, papillary thyroid cancer is characterized by:

• Papillary structures
• Orphan Annie eye nuclei
• Psammoma bodies

Histopathological image of papillary carcinoma of the thyroid

Treatment

The primary treatment for papillary thyroid cancer is surgical removal of the thyroid gland (thyroidectomy). Depending on the extent of the disease, this may be followed by radioactive iodine therapy to ablate any remaining thyroid tissue or metastatic disease. Patients are often placed on thyroid hormone replacement therapy to suppress TSH and reduce the risk of recurrence.

Prognosis

The prognosis for papillary thyroid cancer is generally excellent, with a high survival rate, especially in younger patients and those with localized disease. Long-term follow-up is necessary to monitor for recurrence.

Also see

• Thyroid cancer
• Follicular thyroid cancer
• Medullary thyroid cancer
• Anaplastic thyroid cancer
• Thyroidectomy

References

• American Thyroid Association Guidelines
• National Cancer Institute

0