Thyroid Cancer

In general, cases of thyroid cancer can be divided into well-differentiated thyroid cancers, poorly-differentiated thyroid cancers, and lymphomas.

• The majority of thyroid masses are benign.
• However, patients with a thyroid mass should visit an otolaryngologist to rule out a malignant condition.

Papillary Thyroid CarcinomThe most common type of well-differentiated thyroid cancers, accounting for about 85 percent of cases, is papillary thyroid carcinoma. It is most often diagnosed in female patients aged 25 to 55, particularly in individuals with a family history of the disease or those who’ve been exposed to radiation.

Symptoms of papillary thyroid carcinoma include:

• Difficulty swallowing
• Hoarseness
• A palpable mass in the neck
• Shortness of breath

Papillary thyroid carcinoma is typically treated with the removal of the thyroid gland, followed by treating the patient with thyroid hormone replacement therapy. Cases in which the mass has metastasized may require the removal of the lymph nodes near the thyroid and, in some cases, further treatment with radioactive iodine. Five-year survival rates for patients who’ve been treated for papillary thyroid carcinoma are upwards of 95 percent.

Follicular Thyroid Carcinoma:Most often occurring in middle-aged and older adults and more common in women than in men, follicular thyroid carcinoma is the second-most common type of thyroid cancer. About ten to 13 percent of well-differentiated thyroid cancers are of this type.

Treatment for follicular thyroid carcinoma is similar to that for papillary thyroid carcinoma. Five-year survival rates are between 70 and 85 percent.

Oncocytic Carcinoma (Hürthle Cell Carcinoma):A relatively rare type of well-differentiated thyroid cancer is this type, representing only about three percent of cases. Oncocytic carcinomas are more aggressive than other well-differentiated thyroid carcinomas. Treatment typically involves thyroidectomy followed by additional treatment with radioactive iodine.

Medullary Thyroid Carcinoma:Four to nine percent of thyroid cancers are medullary thyroid carcinomas, making this the third most common type of thyroid cancer. About 20 to 25 percent of cases occur in individuals with a family history of the disease. Individuals who’ve had medullary thyroid carcinoma should be screened regularly for cancers of the endocrine system. A common symptom of medullary thyroid cancer is a palpable mass in the neck.

Anaplastic Carcinoma: Anaplastic carcinomas are a very aggressive form of thyroid cancer that make up fewer than two percent of thyroid carcinoma diagnoses. These cancers often involve the esophagus and other adjacent structures, often causing hoarseness and difficulty breathing. Anaplastic carcinomas are most commonly diagnosed in the elderly population.

Surgery and external-beam radiation are the most common treatments for tumors in the early stages. In cases of involvement with the airway, the patient may require a tracheostomy so they can breathe.

Lymphoma is diagnosed in fewer than five percent of thyroid cancers. Symptoms of lymphoma include:

• A fast-growing thyroid mass
• Difficulty swallowing
• Hoarseness
• Persistent cough
• Shortness of breath

If caught in the early stages, lymphoma is often treated with radiation and chemotherapy. Lymphomas diagnoses in the thyroid region are most often the non-Hodgkin’s type. Although non-Hodgkin’s lymphoma is still relatively rare in Hashimoto’s thyroiditis patients, there is a known association between the autoimmune condition and thyroid cancers.