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Endocrine glands
Endocrine glands


Thyroid cancer - CT scan
Thyroid cancer - CT scan


Thyroid cancer - CT scan
Thyroid cancer - CT scan


Thyroid enlargement - scintiscan
Thyroid enlargement - scintiscan


Thyroid gland
Thyroid gland


Definition:

Papillary carcinoma of the thyroid is the most common cancer of the thyroid gland.

See also: Thyroid cancer



Alternative Names:

Papillary carcinoma of the thyroid



Causes, incidence, and risk factors:

About 75-85% of all thyroid cancers diagnosed in the United States are papillary carcinoma. It is more common in women than in men. It may occur in childhood, but is typically seen in people between ages 20 and 40.

The cause of this cancer is unknown. A genetic defect may be involved.

High-dose external radiation to the neck increases the risk of developing thyroid cancer. Papillary thyroid cancer in children has also been linked to atomic bomb testing in the Marshall Islands and the 1986 Chernobyl nuclear disaster in the Ukraine.

Radiation given through a vein (through an IV) during medical tests and treatments does NOT increase the risk of developing thyroid cancer.



Symptoms:

Thyroid cancer usually begins as a small bump (nodule) in the thyroid gland, which is located at the front of the neck. However, it should be emphasized that most thyroid bumps are harmless and noncancerous (benign).



Signs and tests:

If you have a lump on your thyroid, your doctor will order blood tests and an ultrasound of the thyroid gland.

If the ultrasound shows that the lump is bigger than 1.0 centimeter, a special biopsy called a fine needle aspiration (FNA) will be performed. This test determines if the lump is cancerous or benign (not cancerous).

Thyroid function tests are usually normal in patients with thyroid cancer.



Treatment:

There are three types of thyroid cancer treatment:

  • Surgery
  • Radioactive iodine
  • Medication

Surgery is done to remove as much of the cancer as possible. The bigger the lump, the more of the thyroid gland must be removed. Frequently, the entire gland is taken out.

After the surgery, most (but not all) patients receive radioactive iodine, which is usually taken by mouth. This substance kills any remaining thyroid tissue. It also helps make medical images more clear, so doctors can see if there is any additional cancer.

If surgery is not an option, external radiation therapy can be useful.

After surgery, the patient will need to take medication called levothyroxine sodium for the rest of their life. This replaces the hormone that the thyroid would normally make.

The patient will need a blood test every 3 to 6 months to check thyroid levels, and an imaging test called a radioactive iodine (I-131) uptake scan once a year.



Support Groups:



Expectations (prognosis):

The survival rate for papillary thyroid cancer is excellent. More than 95% of adults with such cancer survive at least 10 years. The prognosis is better for patients younger than 40 and for those with smaller tumors.

The following factors may decrease the survival rate:

  • Age over 40
  • Cancer has spread to distant parts of the body
  • Cancer has spread to soft tissue
  • Large tumor


Complications:

Complications include:

  • Accidental removal of the parathyroid gland, which helps regulate blood calcium levels
  • Damage to a nerve that controls the vocal cords
  • Spreading of cancer to lymph nodes (rare)
  • Spreading of cancer to other sites (metastasis )


Calling your health care provider:

Call your health care provider if you have a lump in your neck. 



Prevention:



References:

Larsen PR, Kronberg HM, Schlomo M, et al. Williams Textbook of Endocrinology. 10th ed. St. Louis, MO: WB Saunders; 2003:469-473.

Hemminki K. Familial risks for nonmedullary thyroid cancer. J Clin Endocrinol Metab. 2005; 90(10): 5747-5753.

Kumar V, Abbas AK, Fausto N. Robbins and Cotran Pathologic Basis of Disease. 7th ed. St. Louis, MO: WB Saunders; 2005:1177-1180.




Review Date: 3/21/2008
Reviewed By: Stephen Grund, M.D. Ph.D., Chief of Hematology/Oncology and Director of the George Bray Cancer Center at New Britain General Hospital, New Britain, CT. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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