Forms of papillary thyroid carcinoma, symptoms and treatment. Thyroid lymphomas. Follicular thyroid cancer

The diagnosis of "thyroid carcinoma" for many comes as a shock. However, in many cases, cancer can be beaten. In the early stages, carcinoma is successfully treated.

Carcinoma: what is it?

Thyroid carcinoma is the general name for all types of cancer of the gland. A malignant tumor occurs due to the uncontrolled growth of certain thyroid cells. Cells divide and grow, forming a knot.

In differentiated cancer, the cells are encapsulated and easily recognized by ultrasound as a neoplasm.

Important. If atypical cells are not surrounded by a capsule, then it is more difficult to detect them. Such a carcinoma is characterized by aggressiveness, its metastases penetrate faster into the lymph nodes and other organs of the neck.

Causes and signs

Today, not a single scientist will undertake to say exactly why thyroid carcinomas occur. However, many possible causes are known. At the same time, the reasons for the emergence of different types differ to some extent. In 20% of cases, a genetic predisposition will be a factor in the occurrence of medullary carcinoma.

Among the most likely common predisposing factors are:

• The presence of benign tumors of the thyroid gland. In 25% of cases, cancer arises from adenomas, nodes and goiter.
• Living in iodine-deficient areas and eating insufficient amounts of iodine.
• Consuming excess amounts of foods containing iodine.
• Radiation exposure to the head.
• Chronic diseases of the female genital area.

Important! Endocrinologists record an increase in the number of cases with increasing age. Thus, the statistics of the incidence of thyroid carcinoma increases by about 10% for every 10 years of life.

With thyroid carcinoma in the first stages, there are no symptoms. They appear most often when the tumor grows into the lymph nodes or other organs of the neck. Each type of cancer has its own specific symptoms, but there are a number of common ones among them:

• Voice change, hoarseness.
• Difficulties with swallowing.
• Scratching pain in the throat.
• Shortness of breath, dry cough.
• Attacks of suffocation at night.

In aggressive carcinomas, there is often a violation of the stool and weight loss for no reason. With adenocarcinomas - a change in behavior, weakness, irritability, constant fatigue.

All malignant tumors can be divided according to their size:

• Giant carcinomas - sizes from 40 mm in tumor diameter.
• Common tumors are 10 to 40 mm in size.
• Microcarcinomas - up to 10 mm in diameter.

Why are microcarcinomas dangerous?

Thyroid microcarcinoma is a very small malignant thyroid tumor that grows slowly but tends to metastasize (this is different from benign tumors).

In recent published studies, American scientists argue that microcarcinomas can exist in the thyroid gland for up to 30 years, while developing slowly and not giving, at first, metastases to other organs of the neck. However, there are examples when microcarcinomas metastasized not only to the organs of the neck, but also to distant organs. They were able to be identified by histology.

Fact. Detecting such a carcinoma is difficult due to its microscopic size. In some cases, the microtumor was not detected even after surgical exposure of the thyroid gland. It was identified during histological examination.

When considering carcinomas, it is not the size of the tumor that is important, but its aggressiveness. Microcarcinomas are dangerous because, having very small sizes up to 10 mm, they can metastasize.

With timely detection of microcarcinoma of the thyroid gland, the prognosis is favorable.

4 types of thyroid cancer

In fact, scientists differentiate more carcinomas, 4 types being the most common. These are papillary, follicular, medullary and anaplastic thyroid cancer.

papillary carcinoma

Diagnosed in 75-80% of cases. It has the best prognosis for recovery, with stages 1 and 2, 100% of patients survive the 5-year milestone. Papillary cancer responds well to radioactive iodine treatment, and surgical treatment in the first stage can save most of the thyroid gland. Metastases appear only at stage 3.

Important! This tumor often develops inside the gland and metastasizes very slowly. Practically does not recur.

The average age of patients is 40 years. Women get sick 5 times more often than men.

Follicular

Found in 15% of patients. It is characterized by a more aggressive course and the rapid occurrence of metastases. Most often, metastases develop in the organs of the neck, then in the lungs, brain, liver, bones, and skin.

The average age of the patients is 47 years. Women get sick more often than men, 3 times.

Hürthle cell type of follicular cancer

Aggressive are adenofollicular tumors that produce the hormone T3. They occur in 1-2% of cases, are similar in structure to follicular ones.

Important! The prognosis is unfavorable. The tumor is aggressive, has a high percentage of deaths. This type of carcinoma occurs at any age and does not differ by gender.

Medullary

The incidence of this tumor is about 8% of cases. Differs in considerable aggressiveness. Very quickly gives metastases to the organs of the neck and lymph nodes. Often does not have a capsule, which contributes to a very rapid spread. It is resistant to chemotherapy and radiation.

This form of cancer is classified as adenocarcinoma, as it contributes to increased production of the hormone calcitonin.

In 20% of cases, medullary carcinoma is caused by genetic factors, and 80% is due to sporadic cancer (caused by other common causes).

The average age of patients is 46 years. When sporadic cancer occurs, women over 40 are more likely (3 times) to get sick. In the hereditary form, there are no gender differences.

Anaplastic

This is a very aggressive, rare (up to 2% of cases) form of thyroid carcinoma that affects the elderly (mean age 72 years). It develops very quickly. It is characterized by a large knot on the front of the neck.

Important! This form of cancer is characterized by a high level of deaths, 7% of patients survive to the 5-year milestone.

What is adenocarcinoma?

Adenocarcinoma is a tumor that develops from glandular (those that produce hormones) cells of the thyroid gland. Adenocarcinoma produces hormones and is doubly dangerous.

Adenocarcinomas include almost all types of thyroid cancer: papillary, follicular, medullary, and in some cases anaplastic.

Treatment

Treatment of carcinoma involves 4 components:

• Chemotherapy. It is used after radiation and thyroidectomy surgery. With papillary and follicular cancer, radioactive iodine treatment is possible, in the case of other types of carcinoma, more aggressive drugs are used.
• Surgical removal of the affected organ. When performing a thyroidectomy, all aspects of the examination and the type of cancer are taken into account. With papillary carcinoma, partial removal of the gland is possible. However, other types involve almost complete excision of the thyroid gland, as well as the cervical lymph nodes.
• Radiation exposure. Applied in the detection of metastases in the organs of the neck. This is most relevant for medullary and anaplastic types of cancer.
• Hormone replacement therapy is used almost always (with the exception of cases of partial removal of the thyroid gland). The small amount of thyroid cells left behind cannot provide the body with the required amount of thyroid hormones. Lifelong hormonal correction is required.

Recovery prognosis

Diagram "Survival of patients at the turn of 5 years after surgery"

In the first stage of follicular and the first and second stages of papillary cancer, the survival rate for 5 years is 100%.

Slightly lower survival rate in the second stage of the follicular and the first and second medullary - 98-95%. The prognosis for the third stage is less favorable: 93–71%.

The most disappointing is the forecast for the fourth stage: 51-28%. With undifferentiated carcinomas, the survival rate ranges from 40% in the first stage to 7% in the fourth. With anaplastic cancer, 7% of patients survive to the age of 5.

One of the most common cancers of the thyroid gland is carcinoma. It occurs most often in older women and is treatable in most cases. A tumor can arise as an independent neoplasm in healthy tissues, as well as from degenerated cells of benign tumors. To detect papillary thyroid carcinoma, you must carefully consider the appearance of any suspicious signs and sensations in the area of ​​\u200b\u200bits location, immediately consult a doctor for removal.

Papillary carcinoma usually forms as a single nodule, very rarely there is the formation of several nodules. Usually one of the lobes of the thyroid gland is affected. Tumors range in size from a few millimeters to 5 cm.

A small neoplasm is mobile (moves freely on palpation, shifts when swallowing). But as it grows, when it grows into neighboring tissues of the gland, mobility disappears. Cancer cells of this type usually spread only to the nearest lymph nodes (95% of tumors) and very rarely enter other organs (larynx, trachea, lungs, and bones). The low "aggressiveness" of this type of tumor allows doctors in most cases to cope with the disease and completely cure patients.

A feature of papillary thyroid cancer is that the tumor is hormonally inactive, that is, it does not produce hormones and does not cause signs of their excess in the body.

A neoplasm of this type develops very slowly, at the initial stage it resembles a cyst or a benign tumor. The formed papillary node under the microscope looks like a capsule with jagged edges, from which papillae extend, capable of growing into neighboring tissues of the thyroid gland. Inside the tumor there are inclusions of calcium.

Forms of the disease

The disease can occur in various forms:

1. Typical, in which the neoplasm grows slowly, characteristic symptoms gradually appear.
2. Hidden when the tumor is small in size and located deep in the thyroid gland. At the same time, it is impossible to detect it by palpation or by external manifestations.
3. Follicular-papillary, in which the tumor contains not only papillary, but also follicular cells.
4. Oncocytic - papillary carcinoma of the thyroid gland, which is characterized by distant metastasis. This form occurs only in 5% of patients.
5. Solid - arising in a person who has undergone radioactive exposure. The tumor spreads faster than usual throughout the thyroid gland, blood vessels and nearby lymph nodes are affected.
6. Diffuse-sclerotic. Most often found in children aged 7-14 years. The tumor is formed from fibrous tissue cells. It contains many cysts covered with papillae. Cancer cells usually penetrate into the cervical lymph nodes, less often into the lung tissue. The disease in this form is the most dangerous.
7. Clear cell, which is characterized by the spread of metastases to the kidneys (this occurs only in 0.3% of cases).

Papillary carcinoma is 3 times more common in women than in men. It is usually found in people aged 30-50 years.

Symptoms of papillary carcinoma

It is almost impossible to detect a papillary tumor, which has a small size, by external manifestations. The seal is not palpable, there is no pain in the neck and any other discomfort. There are no signs of hormonal disorders.

Non-specific symptoms and signs

With the gradual growth of the tumor, the first signs of the disease appear: sore throat, feeling the presence of a coma in it, difficulty in swallowing and breathing, hoarseness, dry skin, swelling of the neck. Thyroid dysfunction leads to hypothyroidism (lack of thyroid hormones). Its symptoms are weakness, low blood pressure, slow pulse, dizziness.

After the spread of cancer to the nearest lymph nodes, signs appear that indicate the occurrence of edema in them: sore throat, discomfort in the chest and armpits. In the last stages of the disease, symptoms of damage to other organs occur. There are also signs characteristic of severe intoxication of the body: a sharp weight loss, the appearance of an earthy skin tone. The patient is haunted by severe pain that can only be drowned out with the help of narcotic drugs.

All these symptoms are classified as non-specific, characteristic not only for papillary thyroid cancer, but also for some of its other diseases.

Specific Symptoms

Specific signs indicating the formation of a papillary tumor are the presence of painless nodes with papillary processes, the spread of the tumor to the lymph nodes, its slow growth and the absence of signs of hyperthyroidism.

Stages of papillary cancer

There are 4 stages of development of papillary carcinoma, taking into account the gradual change in its size and the degree of spread of cancer cells. Characterizing the signs of the disease of stages 1 and 2, experts distinguish 2 age categories of patients: younger than 45 years and older than 45 years. This allows them to more accurately predict the consequences of the disease and the survival rate.

Causes

Thyroid carcinoma occurs due to the fact that under the influence of some adverse factors, a mutation of the cells of this organ occurs.

Mutations can be caused by:

1. Impact on the body of radioactive radiation. A tumor of the thyroid gland occurs in people who have been in a zone of increased radiation. The formation of carcinoma can also be a consequence of radiation therapy performed for cancers of other organs.
2. Malignant degeneration of benign tumor cells (goiter).
3. Changes in the hormonal background, which occur in women during life much more often than in men. Fluctuations in the levels of various hormones occur during each menstrual cycle. Puberty, pregnancy, childbirth, menopause - all these are important physiological periods associated with significant fluctuations in hormone production both in the thyroid gland itself and in other endocrine organs.
4. Metastasis of cancerous tumors formed in other parts of the body (mammary glands, intestines).
5. Inflammatory processes in the thyroid gland, leading to disruption of its functioning.
6. Weakening of the body's immune resistance to the reproduction of cancer cells, as well as the presence of autoimmune thyroid diseases.
7. Iodine deficiency due to malnutrition or lack of this element in the drinking water or soil of the area.

The predisposition to the disease may be hereditary. Contributes to the development of carcinoma pollution of the natural habitat, as well as the habit of smoking, frequent drinking.

Video: How thyroid cancer is diagnosed. Importance of prevention

Diagnosis and treatment

The presence of cancerous nodes in the thyroid gland is detected using ultrasound. Their number, shape, location and size are estimated, which allows us to make an assumption about the stage of the disease. In case of doubt about the nature of the tumor larger than 1 cm, a fine-needle biopsy and histological examination of tissues are performed.

X-ray, MRI, CT are used to detect metastases. The basis of treatment is the surgical removal of the papillary tumor of the thyroid gland, followed by radiation and chemotherapy, as well as therapy using radioactive iodine.

Surgical treatments

Partial or complete removal of the thyroid gland is performed. The technique is chosen in accordance with the size of the tumor and the degree of its spread.

Partial excision (thyroidectomy). It is performed when the tumor size is less than 1 cm and there is no metastasis to the lymph nodes or other organs, while a single seal is found only in one of the thyroid lobes. The tumor itself is cut out, a part of the surrounding healthy tissue is captured. Most often, there is no lack of thyroid hormones after such an operation, since they are produced in the 2nd lobe. The need for hormone therapy is rare.

Total thyroidectomy. Both lobes and the isthmus of the thyroid gland, as well as cervical lymph nodes affected by metastases, are removed. After the operation, the patient must take L-thyroxine for life (a drug that is a synthetic analogue of thyroid hormones of the thyroid gland). The dose of the drug is selected gradually, according to the results of blood tests. In the case of hypothyroidism, the dose of the drug is increased, in case of hyperthyroidism, it is reduced.

Thyroidectomy is a fairly simple operation, after which the patient's health is quickly restored. A complication may be a change in the timbre of the voice due to damage to the vocal nerve. Extremely rarely, damage to the parathyroid glands occurs, which leads to a violation of phosphorus-calcium metabolism.

Radioiodine therapy

It is performed more frequently after surgery or cancer recurrence. Reception in the form of solutions or capsules of preparations of radioactive iodine-131 leads to the destruction of tumor cells. Therapy is carried out within 2-3 months. Stop taking any hormonal drugs in advance. The patient does not experience any discomfort associated with taking iodine preparations. Only the thyroid gland itself is exposed to it. It does not apply to other organs.

Radiation therapy and chemotherapy

They are used only for stage 4 carcinoma, when extensive spread of metastases occurs.

Prognosis for a cure

The prognosis for recovery from papillary thyroid carcinoma is favorable. After removal of the tumor, patients can live from 5 to 20 years, depending on the stage of cancer treatment. The five-year survival rate for patients with stage 1-2 carcinoma is almost 100%. With stage 3 disease, it is 93%. After treatment of patients with stage 4 disease, survival for 5 years is observed in 50-70% of patients.

After treatment, the patient should periodically undergo a preventive examination: check the content of thyroid hormones in the blood, do an ultrasound scan, a study of radioactive iodine (scintigraphy).

Video: Control monitoring of the state of the thyroid gland after surgery

Carcinoma (cancer) of the thyroid gland is not so common in medical practice: it accounts for about 1% of all cancers. Nevertheless, it requires serious attention, both from the doctor and the patient: the sooner it is diagnosed, the better the prognosis for the patient will be.

Our detailed review and video in this article will help you figure out what this pathology is, what morphological types distinguish it (papillary, medullary, follicular thyroid carcinoma), how to recognize cancer at an early stage, and defeat the disease forever.

Despite extensive clinical research being carried out in relation to oncopathology, the exact causes of thyroid cancer are not yet known.

Among the risk factors that provoke malignant degeneration of cells, there are:

• iodine deficiency in the environment;
• goiter, benign tumors of the thyroid gland;
• hereditary predisposition (thyroid carcinoma in one of the close blood relatives);
• hormone-dependent tumors in women (cancer of the ovaries, uterus, mammary glands);
• hormonal fluctuations caused by pregnancy and childbirth, menopause;
• harmful factors at work (ionizing radiation, heavy metals).

Note! Age is another risk factor for thyroid carcinoma. This disease often develops in women over 40-45 years of age and in men over 55 years of age.

Carcinoma occurs from the papillary or medullary epithelium of the thyroid gland.

The tumor may be:

• primary developing directly from the tissues of the endocrine organ;
• secondary, provoked by the germination of cancer cells in the thyroid gland from neighboring organs, as well as their hematogenous or lymphogenous spread.

Important! Benign tumors can also degenerate into carcinoma over time. Therefore, thyroid adenoma in most scientific sources is considered as a precancerous condition and requires dynamic monitoring.

Morphological classification

Depending on the morphological type of cells from which the tumor develops, and the degree of their differentiation (maturity), several types of thyroid carcinoma are distinguished.

papillary carcinoma

Papillary cancer ranks first in prevalence. It accounts for about 70% of all malignant tumors of the thyroid gland.

This form of carcinoma got its name due to the special morphological structure. If you look at a tissue section under a microscope (pictured), you can see the characteristic papillary (from the Latin papilla - papillary) protrusions on the surface of cancer cells.

As a rule, such carcinoma has a favorable prognosis: the tumor grows slowly and in 80-90% of cases affects only one lobe of the thyroid gland. Somewhat worsens the chances of recovery metastasis to nearby lymph nodes.

Follicular carcinoma

Follicular adenocarcinoma of the thyroid gland occurs in 5-10% of cases of all malignant lesions of the organ. It develops from follicular (producing thyroid hormones) cells.

Note! Along with hereditary predisposition, the main factor in the development of follicular thyroid cancer is the lack of iodine in the body.

This form of malignancy is considered more aggressive, but rarely spreads beyond the thyroid gland. Metastasis to the lymph nodes, lungs and bone tissue occurs in the case of late diagnosis and lack of adequate treatment.

Medullary carcinoma

The medullary type of malignant lesions of the thyroid gland is rare: it accounts for about 5%. Such carcinoma develops from the parafollicular cells of the organ (C-cells), which are responsible for the production of the hormone calcitonin.

Medullary cancer is prone to spread, so its distant metastases to the lymph nodes, trachea, lungs and liver can be diagnosed even before the primary focus is determined.

microcarcinoma

Thyroid microcarcinoma is a specific subgroup of thyroid tumors that are less than 1 cm in size. This form of cancer can develop from any type of cell - papillary, follicular or medullary. Although small, this carcinoma can be very aggressive and spread to nearby lymph nodes.

Clinical signs: how to recognize the first signs of the disease

The symptoms of thyroid carcinoma are not always obvious, so the disease can go unnoticed for a long time. A palpable dense nodule on the neck, the size of which ranges from 5 millimeters to several centimeters, makes the patient pay attention to the health problems of the patient.

Is a thyroid nodule always cancer?

Do not be alarmed ahead of time: most of the nodules in the thyroid gland are not cancer. Even if the node reaches a significant size, in 95% of cases it is benign. The prevalence of nodular goiter increases with age: it is a common problem in people over 35-40 years of age.

Nevertheless, it is important for each patient to undergo a comprehensive examination in order to accurately determine the morphological structure of the node.

Typical signs of carcinoma

Most often, patients with thyroid cancer go to the doctor with complaints of:

1. One or more knots in the neck. With carcinoma, the formation is dense to the touch, has bumpy edges.
2. Swelling of the neck can be noticeable with a significant size of nodular formations, especially when the patient makes swallowing movements.
3. Enlargement of regional cervical lymph nodes.
4. Hoarseness occurs when a large tumor node compresses the larynx and disrupts the process of normal sound production.
5. Violation of free breathing and swallowing appears with the pressure of the tumor node on the trachea and esophagus.
6. Pain in the throat and neck area is also sometimes found in thyroid carcinoma. They are not a typical symptom of the disease, but may indicate extensive damage or spread of cancer to neighboring organs.

Methods for early diagnosis

The standard algorithm for examining patients with suspected thyroid cancer is presented below:

• Collection of complaints and anamnesis. Tell the doctor in detail about when the first signs of the disease appeared, whether you took any drugs or traditional medicine made by yourself.
• Examination and palpation of the thyroid gland will allow the doctor to determine the size, density and consistency of the tumor node.
• Lab Tests:
  1. general clinical blood and urine tests: with carcinoma, leukocytosis, anemia (decrease in hemoglobin levels), accelerated ESR are observed;
  2. analysis for thyroid hormones: TSH, T3, T4; is prescribed to assess the endocrine function of the thyroid gland;
  3. determination of the level of thyroglobulin - a specific carrier protein, the concentration of which increases with thyroid cancer. This allows us to consider this substance as a tumor marker.
  4. Analysis for calcitonin (increased in medullary thyroid cancer).
• Instrumental research methods:
  1. Ultrasound of the thyroid gland and cervical lymph nodes;
  2. Biopsy with morphological examination of the obtained biomaterial.

Morphological examination is the main method for diagnosing cancer

To reliably determine the morphological structure of the cells of the tumor node and confirm or refute the diagnosis of carcinoma, it is necessary to conduct a fine-needle biopsy with a study of the obtained biological material. The procedure is carried out under ultrasound control and consists in piercing the neck and taking a small piece of thyroid tissue.

Microscopy of the obtained sample will determine the cellular structure of the formation and make a correct diagnosis, including the type and extent of the tumor.

Table 1: Indications for biopsy:

Principles of treatment

The main method of radical treatment of carcinoma is the surgical removal of the thyroid gland. A promising direction in the therapy of highly differentiated forms of cancer is the use of radioactive iodine (I131 isotope).

This method of treatment makes it possible to achieve targeted destruction of tumor cells that were not removed during the operation, as well as to fight distant metastases.

Important! Modern medical instructions do not require the immediate removal of small (less than 1 cm) thyroid nodules, which have become an accidental finding on ultrasound. If the patient does not complain, and the hormonal background is not disturbed, dynamic monitoring is preferable.

Taking levothyroxine preparations will help to ensure the body's need for thyroid hormones and prevent the re-growth of thyroid tissue. The selection and correction of the dosage of the agent is carried out by the doctor individually on the basis of laboratory and clinical data.

Forecast

In most cases, thyroid carcinoma is a curable disease. A favorable prognosis is considered for young patients with papillary, follicular and, to a lesser extent, medullary cancer.

Adverse factors for the life and health of the patient can be called:

• elderly age;
• large size (4 cm and above) of the primary tumor;
• the presence of metastases in the brain and internal organs.

Note! The prognosis of thyroid carcinoma depends not only on the stage of the tumor process, but also on the degree of differentiation of cancer cells. Highly differentiated (mature) forms of the tumor are considered less aggressive and rarely cause damage to neighboring organs or germination into blood vessels. Poorly differentiated (immature, similar in structure to stem cells) forms are more malignant and lead to the development of complications.

Despite the difficulties in the diagnosis and treatment of malignant tumors of the thyroid gland, papillary, follicular or medullary carcinoma has a relatively favorable course and prognosis for the patient. After the therapy, most patients are considered recovered, and with the exception of the need for daily hormonal drugs, their lives return to normal.

Papillary thyroid carcinoma accounts for the majority of neoplasms of this organ. However, the tumor responds well to treatment, as a result of which the prognosis for this disease is favorable.

The likelihood of developing the disease increases in the presence of risk factors such as:

• hereditary predisposition,
• polluted ecology,
• malnutrition,
• Smoking,
• Stress and excessive exercise.

Pathogenesis

Cancer nodule most often affects one lobe of the gland. In the case of the initial appearance of a tumor in the isthmus, the risk of damage to both lobes is high.

Initially, the knot is smooth to the touch, slightly denser than the surrounding healthy tissue. Later, the tumor becomes rough, without clear boundaries. Gradually, the cancer grows into neighboring organs, compresses them, as a result of which additional symptoms may appear:

• hoarse voice,
• the appearance of shortness of breath,
• difficulty swallowing,
• the severity of the vascular pattern on the skin of the neck.

The progression of the disease is characterized by metastasis to the lymph nodes on the side of the lesion. In this case, the lymph nodes are greatly enlarged in size.

Classification

There are two types of papillary carcinoma: papillary variant and follicular.

In the first case, both the tumor and metastases do not have hormonal activity. Accordingly, it is pointless to carry out therapy with the use of radioactive substances in this variant. With the follicular type of papillary carcinoma, the tumor is hormonally dependent and responds well to radioiodine therapy.

Diagnostic criteria

Papillary carcinoma has a slow pace of development. Therefore, patients who have the corresponding symptoms often turn to the doctor. These signs include tightness in the neck, voice change, difficulty swallowing, and frequent choking.

This pathology of the thyroid gland most often manifests itself in the form of a single node, less often - multiple. Nodes larger than 1 cm are determined by palpation. In this case, the tumor has a dense, bumpy texture and is displaced on palpation along with the skin. In rare cases, when germinating into neighboring organs, it loses mobility.

For the prevention and treatment of thyroid diseases, our readers advise Monastic Tea. It consists of 16 of the most useful medicinal herbs, which are extremely effective in the prevention and treatment of the thyroid gland, as well as in cleansing the body as a whole. The effectiveness and safety of Monastic Tea has been repeatedly proven by clinical studies and many years of therapeutic experience. The opinion of doctors ... "

Laboratory diagnostics in this case is not very informative, since almost 95 percent of cases of the disease are hormonally inactive.

Ultrasound of the thyroid gland allows you to determine the type of tumor, its size, possible metastasis and germination in neighboring organs.

Fine-needle aspiration biopsy is the method of disease verification for making a final diagnosis. The area of ​​pathological tissue taken for analysis is examined microscopically. The preparation under the microscope is a branching system, consisting mainly of connective tissue and covered with a cylindrical and cubic epithelium. This type of cancer is supplied with a network of blood vessels. Visually, the structure of papillary carcinoma resembles a fern leaf.

Papillary carcinoma is characterized by the following changes:

• Rebirth from a benign tumor;
• Mild symptoms in the early stages of the disease;
• The rapid pace of development of carcinoma;
• Variability in size: it can be either a microcarcinoma or a tumor with a volume of several centimeters;
• Lack of neoplasm capsule;
• Metastasis to lymph nodes.

Differential Diagnosis

Well-differentiated thyroid tumors are collectively referred to as adenocarcinoma. These include follicular, papillary, and medullary cancers. Different types of malignant tumors have their own characteristic features. They are the differential diagnostic criteria for the diagnosis of papillary carcinoma.

1. Follicular carcinoma. This tumor is encapsulated and is rarely found on biopsy.
2. medullary carcinoma. Has a hereditary predisposition. When conducting a blood test, an increase in the hormone calcitonin is observed, and the node is clearly visualized on ultrasound.

Principles of treatment

Treatment of papillary carcinoma involves total thyroidectomy - the complete removal of the thyroid gland. This is done in order to eliminate the risk of re-neogenesis and metastasis from possibly remaining cancer cells. Additionally, conservative therapy with the use of radioactive pharmaceuticals is connected.

After such treatment, lifelong thyroid hormone replacement therapy is required.

The survival rate for timely diagnosis of papillary carcinoma is high. Although it is the most common of all thyroid neoplasms and affects even young children, it is the least dangerous and responds well to treatment.

It still seems that it is not easy to cure the thyroid gland?

Given that you are now reading this article, we can conclude that this ailment still haunts you.

You probably also had thoughts about surgery. It is clear, because the thyroid gland is one of the most important organs on which your well-being and health depends. And shortness of breath, constant fatigue, irritability and other symptoms clearly interfere with your enjoyment of life...

But, you see, it is more correct to treat the cause, not the effect. We recommend reading the story of Irina Savenkova about how she managed to cure the thyroid gland...

Among the variety of cancerous tumors found in the body, thyroid cancer (carcinoma) does not occupy a leading position in terms of frequency of occurrence. However, its appearance has recently become more frequent, especially among young citizens. Statistically, the elderly remain the leaders in the development of the disease, and every ten years the incidence rate equivalently rises by ten percent.

Tumors of a benign nature are noted more in women, men are more likely to degenerate nodes into malignant ones. A small proportion of thyroid carcinomas are inherited.

Signs of the appearance of carcinoma

More often, a malignant tumor degenerates from a benign one. At first, the disease does not manifest itself in any way, then the goiter changes its structure, becoming more dense, bumpy. The size of the neoplasm begins to increase.

If a rapidly developing nodule is found without the formation of symptoms, its malignant nature is assumed, despite the fact that single nodes are more often benign.

A malignant nodule usually develops on the underside of one of the thyroid lobes. Sometimes it is found in the isthmus of the gland, then it spreads to both lobes. In the first stages, the tumor is visually smooth, with a denser structure than healthy thyroid tissue. In the course of progression, the neoplasm becomes rough, with blurred boundaries, and gradually begins to occupy the entire share of the thyroid gland. The three-dimensional volume of the tumor also changes: growth goes in the direction deep into the gland, which is why the compression of neighboring tissues, the trachea and the recurrent nerve becomes more and more noticeable. The voice becomes hoarse, shortness of breath begins during physical exertion, other difficulties with breathing. Problems with swallowing (dysphagia) begin, the vascular-venous pattern is clearly visible on the surface of the skin in the region of the gland, the tumor captures more and more tissues, neck muscles.

Lymph nodes on the part of the neck where the tumor is located begin to increase in size, which indicates the degeneration of normal lymphoid tissue into malignant one. This symptom is the main one in diagnosing cancer in children. Compression of the recurrent nerve affects the vocal cord of the affected side, causing paresis in it. Sometimes this does not affect the violation of the timbre of the voice, but the glottis still detects a violation if it is examined by laryngoscopy.

Types of cancer: follicular

An additional nuisance in the detection of follicular cancer from other types of malignant tumors of the thyroid gland is the inability to detect during a biopsy. If the follicular nature of the tumor is detected, the patient is subject to mandatory surgical intervention in order to remove the affected lobe of the gland. To distinguish follicular carcinoma of the thyroid gland from follicular adenoma allows the study of the capsule of the node: with carcinoma, a tumor grows into it.

Types of cancer: medullary

Medullary thyroid carcinoma is less common (only about 6% of all thyroid carcinomas). It is mainly treated surgically. There are two forms of this type of neoplasm:

1. sporadic. The most common form (4 cases out of 5) is not inherited.
2. family. Has a hereditary predisposition, is transmitted along with pheochromocytoma (a tumor in the adrenal glands) and parathyroid carcinoma or parathyroid adenoma (tumors in the parathyroid glands).

These forms of tumors can be distinguished using a genetic study of the 10th chromosome. This chromosome is the localization site of the RET proto-oncogene responsible for the synthesis of tyrosine kinase.

The presence of a mutation in the RET proto-oncogene is the basis for examining close relatives of the patient.

Elevated levels of the hormone calcitonin and a nodule detected during an ultrasound examination indicate medullary carcinoma and immediate surgical intervention.

The promptness of treatment (radioactive iodine treatment is not used in this case) is due to the aggressive nature of this type of cancer. In addition to surgical removal of the gland, tyrosine kinase inhibitors are used.

Types of cancer: papillary

Papillary thyroid carcinoma is the most common cancer of all thyroid carcinomas (about 80% of cases). The least dangerous, develops slowly, occurs even in newborns.

Tumors do not have capsules, their size can vary from a few mm to 4 cm or more. Papillary carcinoma has the appearance of a fern leaf, with a branching stem, the center of which can deposit calcium compounds. In the papillary variant of papillary carcinoma, both the tumor and metastases do not have hormonal activity, and therefore cannot capture the radioactive isotope of iodine-131. The follicular variant of papillary carcinoma exhibits hormonal activity and is therefore treated with radioiodine therapy. In both variants, spread occurs through the lymphatic vessels, and metastases often enter the lymph nodes on the respective side.

The disease often manifests itself in the form of a single node, less often - multiple nodes. Palpation fails to detect thyroid carcinoma less than 10 mm in size. Even such small neoplasms can metastasize to the lymph nodes on the corresponding side of the neck. However, the sluggish nature of cancer makes it possible to establish a favorable prognosis even for such small tumors.

Usually, the tumor is displaced when moving along with the skin. If, nevertheless, it grows into neighboring tissues and organs, it becomes immobile both when swallowing and when trying to move.

Metastases can develop over several years, and only 6 out of ten patients found metastases in the cervical lymph nodes.

It is possible to avoid the appearance of metastases when removing the thyroid gland with benign nodes. In addition to metastases involving lymph nodes, cases of metastasis to another lobe of the thyroid gland are described. And very rare cases of cancer cells spreading to the lungs, bones, etc. If this happens, it is papillary carcinoma with encapsulated follicular metastases. In the diagnosis, cancer is recognized only by bone fractures or pain that occurs using x-rays. There are no signs of the disease from the thyroid gland (euthyroid character).

The lethal outcome after the operated papillary cancer is very rare. If such cases occur, then the cancer returns to the rest of the thyroid gland. Almost always it is possible to remove metastases even from bones with iodine-131.

If it is impossible to detect the node by palpation, and metastases to the lymph nodes are obvious, the result of the histological examination of the lymph node decides the issue. Until this moment, the origin of metastases remains a mystery: lymphogranulomatosis, tuberculosis of the lymph nodes, or papillary carcinoma of the thyroid gland.

Although the absence of metastases to the lymph nodes (or single metastases) allows you to save part of the thyroid gland, the practice of surgeons is more radical.

Their fears are understandable: after all, the percentage of metastasis through the lymphatic vessels to the neighboring lobe is quite large and it is not advisable to subject the body to a second operation. Therefore, total thyroidectomy is often used. Sometimes, after surgery, the neck area at the site of the former thyroid gland and local lymph nodes is subjected to x-rays, although papillary carcinoma is not very sensitive to these rays.

Types of cancer: anaplastic

Anaplastic carcinoma is diagnosed in elderly patients. Occurs very rarely. It refers to tumors of an undifferentiated nature, since cancer cells do not have a common functionality with thyroid cells. Therefore, the use of radioiodine therapy is useless. It is found when there are already both metastases in the lymph nodes and distant ones. Due to the late terms of treatment of patients, when there are difficulties in swallowing, breathing, a hoarse voice, patients are shown not only surgery, but also subsequent radiation and chemotherapy for recovery.

Varieties of cancer: Hürthle cell

This form is similar to follicular cancer, the feature is more metastasis.