Thyroid and Parathyroid tumors


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Thyroid and Parathyroid tumors

Thyroid gland is located on front side of the neck and is shield shaped from which it derives its name. Thyroid gland tumors are among the most common endocrine tumors. Radiation exposure to neck during childhood either for treatment or any diagnostic test, commonly cause thyroid cancer. Long standing enlargement of thyroid also predisposes to thyroid malignancy. Parathyroid glands are situated back side of the thyroid gland and are four in number. They are among the least common malignant tumors of the body.

  • Symptoms
  • Treatment

Clinical Features and Diagnosis 

Thyroid tumor commonly presents as swelling in neck, the incidence is higher in women as compared to men. Ultrasound of the neck is common investigation performed in cases of neck swelling and may help in characterizing the lesion. CT scan of neck gives an idea about the anatomical extent of the tumor and also reveals enlarged neck node which is common site of metastasis. Confirmative diagnosis is made by ultrasound guided Fine Needle Aspiration Cytology (FNAC), which typically reveals the malignant cell morphology. Serum tumor marker i.e thyroglobulin (Tg) is markedly elevated in thyroid tumors and also help in monitoring recurrence after definitive treatment. Parathyroid tumors commonly present due to symptoms of calcium excess in body due to parathyroid hormone secreted by these tumors which stimulates calcium absorption in body. Calcium excess in body leads to renal stones and blocked arteries ( leading to heart attacks) which are commonly presenting symptoms in parathyroid carcinoma. Localization of parathyroid gland is best done sestamibi SPECT scan

Treatment

Surgery remains the corner stone of the treatment in thyroid malignancy. Surgery is either total or near total thyroidectomy. Enlarged neck nodes involved by tumors may require formal neck dissection. Post operative radio iodine treatment with I131 is required in locally advanced or metastatic disease. Thyroid replacement therapy required after total thyroidectomy. 

Surgery is also the treatment of choice in parathyroid carcinoma, in large tumors of parathyroid may require excision of thyroid gland for enbloc removal of cancer. Management of calcium excess in body is difficult situation in metastatic or locally advanced parathyroid cancer.

GENERAL INFORMATION





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