Thyroid gland
Thyroid cancer - general


Author: Shahidul Islam, M.D., Ph.D. (see Authors page)

Revised: 1 December2016, last major update March 2009

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

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Cite this page: Thyroid cancer - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/thyroidthyroidca.html. Accessed December 8th, 2016.
Definition / General
Epidemiology
Prognostic Factors
  • 20 year survival is 90%, because most are indolent papillary carcinomas
  • Good prognostic factors:
    • Men under age 40 years or women under age 50 / 60
    • Favorable histologic types
  • Poor prognostic factors:
    • Men age 41+ or women 51+
    • Large tumor size, nuclear pleomorphism, tumor necrosis, vascular invasion, increased mitotic activity, higher stage, unfavorable subtypes (Am J Surg Pathol 2002;26:1007)
  • Death usually from undifferentiated, poorly differentiated, Hürthle cell or medullary carcinoma, due to distant metastases
  • Poor survival in those with bone metastases (5 year: 29%, 10 year: 13%, Arch Pathol Lab Med 2000;124:1440)
Treatment
  • See also subtypes - either lobectomy, subtotal thyroidectomy or total thyroidectomy; also postoperative radioiodine therapy, TSH suppressive therapy, new molecular therapies (Ther Clin Risk Manag 2008;4:935)
  • Can assess for recurrence with serum thyroglobulin levels (different assays show good agreement between themselves, Clin Biochem 2009;42:416), calcitonin (medullary carcinoma)
Micro Images
Images hosted on PathOut server:

Diffuse positive staining for CK19, Galectin-3 and HBME-1

Positive Stains
Negative Stains
Molecular / Cytogenetics Description
  • Rearrangements of RET-PTC in 40% of papillary carcinomas, rearrangements of PAX8-PPARy in 40% of follicular carcinomas, BRAF mutations in 40-60% of papillary carcinomas (Arch Pathol Lab Med 2008;132:164)
Differential Diagnosis