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Thyroid Cancer

Thyroid mass

Thyroid mass

The thyroid is a small gland shaped like a butterfly that sits in the lower part of your neck in front of your windpipe. The function of the gland is to produce hormones. The main hormone released by the gland is thyroxine. The normal action of thyroid hormones is to keep all bodily functions occurring at a correct rate.

Thyroid cancer usually present as a nodule or lump in the neck called a thyroid nodule. Thyroid nodules are relatively common, occurring in between 4 – 10% of the general population, although autopsy studies have reported up to 50% incidence in post-mortems on patients with no known thyroid disease. Most thyroid nodules are benign (90%).

There is a higher incidence of thyroid cancer in females (3.5 :1) but patients at extremes of age ( 50 years) and males are more likely to harbour a cancer within a thyroid nodule.

Is it deadly?

Thyroid cancer spans the entire spectrum of clinical aggressiveness, from micropapillary carcinoma (often incidentally found, and measuring less than 10mm by definition) that does not impact patient survival, to anaplastic carcinoma, which results in death within 6 months.  The commonest type of thyroid cancer is papillary carcinoma.

How to detect Thyroid Cancer?

The most important investigative modality is the fine needle aspiration biopsy (FNAB) that can be performed in the clinic, with minimum morbidity and often without local anaesthesia. This test tells us with about 80-90% accuracy whether the thyroid nodule is benign or malignant

Though less accurate in predicting whether a thyroid nodule is malignant, the thyroid ultrasound is still a useful tool in that it provides excellent anatomic detail regarding the nodule, accurate measurements (which are useful if the nodule is to be managed conservatively) and it provides information about the entire gland configuration that includes the presence of subclinical nodules in the contralateral lobe. It also allows for the evaluation of subtle central and lateral neck node enlargement. Features that suggest malignancy on ultrasound are central microcalcifications, irregular or blurred margins, marked hypoechogenicity, intranodular vascular pattern and an incomplete peripheral halo.

Treatment for Thyroid Cancer

Surgery is the most common form of treatment for thyroid cancer that has not spread to distant parts of the body. A part or the entire thyroid and any other affected tissue, such as the lymph nodes is usually removed with this procedure. This procedure however may not be recommended when a patient is found to have thyroid cancer that has spread. Treatment may include radioactive iodine therapy, and/or hormone therapy.

Parotid gland tumour

The parotid gland is the largest of our four pairs of major salivary glands. Parotid gland tumours commonly presents as a lump just below the ear lobe with 80% of these tumours being benign.  Fine needle aspiration or CT scans do not have a high level of accuracy in differentiating benign from malignant tumours of the parotid. Hence, growths in the parotid gland require excision via a parotidectomy operation.

Facelift incision in a parotidectomy operation for improved cosmesis

Facelift incision in a parotidectomy operation for improved cosmesis