Endocrine tumours

Published on 09/04/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 09/04/2015

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17 Endocrine tumours

Thyroid cancer

Thyroid malignancies are the commonest endocrine malignancy. Common types of thyroid cancers are papillary and follicular carcinomas (well-differentiated cancers) arising from epithelial cell, medullary carcinomas from the parafollicular C cells, anaplastic carcinoma and NHL. Well-differentiated cancers typically affect women in their 40s. The median age of presentation of medullary carcinoma is 50–60 years and older for anaplastic carcinoma.

Staging

Box 17.1 shows the TNM staging system. The TNM and MACIS (Box 17.2) have been shown to be the best predictors of outcome in differentiated thyroid cancer.

Box 17.1
TNM staging in thyroid cancer

T stage

pT1 Tumour ≤2 cm in greatest dimension
pT2 Intrathyroidal tumour >2–4 cm in greatest dimension
pT3 Intrathyroidal tumour >4 cm in greatest dimension
pT4 Tumour beyond the thyroid capsule

N stage (cervical and upper mediastinal)

N0 No nodes involved
N1 Regional nodal involvement
N1a Ipsilateral cervical nodes
N1b Bilateral, midline or contralateral cervical nodes, or mediastinal nodes

Distant metastases

M0 No distant metastases
M1 Distant metastases
MX Distant metastases cannot be assessed