Thyroid nodule natural history, complications and prognosis
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
|
Thyroid nodule Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Thyroid nodule natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Thyroid nodule natural history, complications and prognosis |
|
FDA on Thyroid nodule natural history, complications and prognosis |
|
CDC on Thyroid nodule natural history, complications and prognosis |
|
Thyroid nodule natural history, complications and prognosis in the news |
|
Blogs on Thyroid nodule natural history, complications and prognosis |
|
Risk calculators and risk factors for Thyroid nodule natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The most common diagnoses and their approximate distributions are colloid nodules, cysts, and thyroiditis (in 80 percent of cases); benign follicular neoplasms (in 10 to 15 percent); and thyroid carcinoma (in 5 percent).
Natural History, Complications and Prognosis
Complications
Noncancerous thyroid nodules are not life threatening. Many do not require treatment. Follow-up exams are enough. The outlook for thyroid cancer depends on the type of cancer.
| Follicular carcinoma | Minimally invasive follicular thyroid cancer | only invasion of the capsule of the tumor without vascular invasion | |
| Encapsulated angioinvasive follicular thyroid cancer | minor vascular invasion (≤4 foci of angioinvasion within the tumor or capsule of the tumor) with or without capsular invasion | ||
| Widely invasive follicular thyroid cancer |
|
Differentiated and anaplastic thyroid carcinoma TNM staging AJCC UICC 2017
| Primary tumor (T) | ||||
| Papillary, follicular, poorly differentiated, Hurthle cell and anaplastic thyroid carcinoma | ||||
| T category | T criteria | |||
| TX | Primary tumor cannot be assessed | |||
| T0 | No evidence of primary tumor | |||
| T1 | Tumor ≤2 cm in greatest dimension limited to the thyroid | |||
| T1a | Tumor ≤1 cm in greatest dimension limited to the thyroid | |||
| T1b | Tumor >1 cm but ≤2 cm in greatest dimension limited to the thyroid | |||
| T2 | Tumor >2 cm but ≤4 cm in greatest dimension limited to the thyroid | |||
| T3 | Tumor >4 cm limited to the thyroid, or gross extrathyroidal extension invading only strap muscles | |||
| T3a | Tumor >4 cm limited to the thyroid | |||
| T3b | Gross extrathyroidal extension invading only strap muscles (sternohyoid, sternothyroid, thyrohyoid, or omohyoid muscles) from a tumor of any size | |||
| T4 | Includes gross extrathyroidal extension | |||
| T4a | Gross extrathyroidal extension invading subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve from a tumor of any size | |||
| T4b | Gross extrathyroidal extension invading prevertebral fascia or encasing the carotid artery or mediastinal vessels from a tumor of any size | |||
| NOTE: All categories may be subdivided: (s) solitary tumor and (m) multifocal tumor (the largest tumor determines the classification). | ||||
| Regional lymph nodes (N) | ||||
| N category | N criteria | |||
| NX | Regional lymph nodes cannot be assessed | |||
| N0 | No evidence of locoregional lymph node metastasis | |||
| N0a | One or more cytologically or histologically confirmed benign lymph nodes | |||
| N0b | No radiologic or clinical evidence of locoregional lymph node metastasis | |||
| N1 | Metastasis to regional nodes | |||
| N1a | Metastasis to level VI or VII (pretracheal, paratracheal, or prelaryngeal/Delphian, or upper mediastinal) lymph nodes. This can be unilateral or bilateral disease. | |||
| N1b | Metastasis to unilateral, bilateral, or contralateral lateral neck lymph nodes (levels I, II, III, IV, or V) or retropharyngeal lymph nodes | |||
| Distant metastasis (M) | ||||
| M category | M criteria | |||
| M0 | No distant metastasis | |||
| M1 | Distant metastasis | |||
| Prognostic stage groups | ||||
| Differentiated | ||||
| When age at diagnosis is... | And T is... | And N is... | And M is... | Then the stage group is... |
| <55 years | Any T | Any N | M0 | I |
| <55 years | Any T | Any N | M1 | II |
| ≥55 years | T1 | N0/NX | M0 | I |
| ≥55 years | T1 | N1 | M0 | II |
| ≥55 years | T2 | N0/NX | M0 | I |
| ≥55 years | T2 | N1 | M0 | II |
| ≥55 years | T3a/T3b | Any N | M0 | II |
| ≥55 years | T4a | Any N | M0 | III |
| ≥55 years | T4b | Any N | M0 | IVA |
| ≥55 years | Any T | Any N | M1 | IVB |
| Anaplastic | ||||
| When T is... | And N is... | And M is... | Then the stage group is... | |
| T1-T3a | N0/NX | M0 | IVA | |
| T1-T3a | N1 | M0 | IVB | |
| T3b | Any N | M0 | IVB | |
| T4 | Any N | M0 | IVB | |
| Any T | Any N | M1 | IVC | |