Thyroid Tumor

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

A tumor of the thyroid gland is a malignant nodule that develops from the C-cells of the organ's epithelium. It is possible that the gland may be damaged by metastases of tumors located in other organs.

According to statistics, in 90% of cases, a thyroid tumor is of a malignant nature. It was found that in 5% of patients with various pathologies of the thyroid gland, an oncological neoplasm undiagnosed during life was found after opening. Nevertheless, despite such a wide spread of the disease, and 5.6% of people out of 100,000 of the population have a tumor (data for 2001), death due to cancer of the thyroid gland is rare. The fact is that this pathology has certain features, namely: it grows slowly, rarely gives metastases, and just as rarely disrupts the work of other organs.

Most often, the tumor is diagnosed in women aged 40 to 60 years. In men, the disease develops 3.5 times less often.

The disease is most often provoked by the following factors:

Prolonged excess in the body of the level of the hormone TSH, which has a stimulating effect on the organ.
Ionizing radiation of the body, which is especially dangerous at a young age.
Autoimmune diseases.
X-ray exposure increases the risk of a thyroid tumor by 5-10 times. The period that elapses between radiation and the formation of a thyroid tumor depends on the age of the patient in which the X-ray examinations were performed. So, if the radiation was carried out in childhood, then the tumor may appear after 10 - 12 years. If in adolescence, then after 20-25 years. If the radiation exposure was provided in adulthood, then the tumor may appear after 30 or more years.
Genetic predisposition to tumor formation. So, as a result of the mutation of the genes 10q11-q12, D10S170, A, a papillary tumor will develop. Due to the mutation of genes 18847, A, a follicular tumor is formed. Medullary tumor will develop due to mutation of the RET oncogene, 10q11.2, A,

The main symptoms that may indicate a tumor of the thyroid gland are: difficulty swallowing food, cough, sore throat, hoarseness, etc.

Content:

Thyroid tumor classification

Symptoms of a thyroid tumor

Causes of a tumor of the thyroid gland

Diagnosis of thyroid tumors

Thyroid tumor treatment

Thyroid tumor classification

The classification of a thyroid tumor is as follows:

Malignant epithelial tumors.
Benign epithelial tumors.
Non-epithelial tumors.

Depending on the histological form of the tumor, the following thyroid neoplasms are distinguished:

Follicular tumor - prevalence 15 to 20%.
Papillary tumor is the most common (60 to 70% of cases).
Medullary - it accounts for about 5% of cases.
Anaplastic - the prevalence is 2 to 3% of cases.
Mixed tumors occur in 5-10 cases.
Lymphomas 2 to 3% of cases.

Follicular thyroid tumor

This tumor is the second most common form of thyroid malignancy, after papillary carcinoma. Most often it is diagnosed in people living in countries where there is an acute lack of iodine in food.

A neoplasm of their follicular cells develops, which make up an integral part of a healthy thyroid gland.

A follicular tumor most often does not spread to the lymph nodes, but its cells are able to metastasize to the lungs, bones and other organs.

Malignant tumor of the thyroid gland

Malignant tumors of the thyroid gland are papillary, follicular, medullary and anaplastic carcinomas.

The most common malignant tumor is papillary carcinoma. The formation grows slowly, often involving the lymph nodes located on the neck in the pathological process. This tumor affects only one lobe of the thyroid gland. Mortality in papillary thyroid tumors is low, and the treatment is most often effective.
Medullary carcinoma originates from glandular cells that produce a hormone that regulates blood calcium levels (calcitonin). Therefore, its presence can be suspected by the high content of calcitonin and carcinoembryotic antigen in the blood. This tumor often metastases, which are found in the liver, lungs, lymph nodes and other organs. Often, metastases are started already at the moment when the tumor was first diagnosed. Treatment prognosis for medullary carcinoma is often poor.
Anaplastic carcinoma is very rare. It is characterized by rapid and aggressive growth, early metastasis to both lymph nodes and distant organs. Therefore, the treatment of this type of tumor is difficult.

Benign thyroid tumor

Benign thyroid tumors are:

Adenomas that form from the follicular epithelium, forming hard nodules. The nodules may merge into a goiter.
Cysts, which are formations that have a capsule filled with fluid inside. Cysts can appear anywhere in the thyroid gland.

Symptoms of a thyroid tumor

Symptoms of a thyroid tumor are as follows:

The feeling that there is an enlarged mass in the neck area. Most often it occurs on one side and is characterized by rapid growth.
The neck in the area where the gland is located will be somewhat edematous.
Pains appear that are localized in the region of the gland and can radiate to the ears.
The voice changes, hoarseness appears.
Difficulty swallowing food.
Possible breathing problems. Choking, coughing, shortness of breath often appear.
The cough is not associated with respiratory infections and is present on an ongoing basis. It has been found that if a thyroid tumor has reached stage 4, then it sends metastases to the lungs in 61% of cases.

The painful sensations that appear during a person's swallowing movements have a stimulating effect on the glands of the throat and larynx. As a result, the patient has a constant feeling of a lump in the throat.

Another symptom of a thyroid tumor is hypothyroidism. This condition is due to the fact that the healthy tissue of the gland becomes less and less, which leads to a decrease in the amount of hormones produced.

The following symptoms indicate the development of hypothyroidism:

Fast fatiguability;
Lethargy, drowsiness, apathy;
Loss of hair, coarsening of the voice.

A follicular tumor of the thyroid gland, on the contrary, leads to increased work of the organ, which provokes the development of hyperthyroidism.

In this case, the symptoms of pathology are:

Hyperhidrosis;
Sleep problems;
Weight loss;
Seizures;
Decreased appetite.

In old age, the general symptoms of a thyroid tumor are more pronounced than in youth. Moreover, the disease progresses faster.

Causes of a tumor of the thyroid gland

It has been established that a tumor of the thyroid gland appears in 80% of cases in those patients who already have goiter.

The following causes of thyroid tumors can be distinguished:

Chronic organ inflammation.
Belonging to the female sex and age over 40-50 years.
Lack of iodine in the body, its low content in food.
Chronic inflammation or tumors of the breast and genital area.
Genetic predisposition to endocrine tumors.
The effect of X-ray or ionizing radiation both on the body as a whole and on the neck and head area in particular. This radiation is especially dangerous in childhood and adolescence.
The presence of an adenoma of the thyroid gland, which can degenerate into a malignant tumor.
Genetic hereditary conditions (Gardner's syndrome, Cowden's syndrome, familial polyposis, etc.).
Hormonal surges in a woman's body occurring during the period of gestation, during feeding and during menopause.

Most often, in order for a tumor to form, it is necessary to influence several factors at once.

Diagnosis of thyroid tumors

Diagnosis of thyroid tumors begins with palpation of the organ in the endocrinologist's office. In the presence of education, the doctor will be able to feel single or multiple dense nodules of various sizes. Malignant tumors are most often adhered to the surrounding tissues, have a bumpy surface and low mobility.

The stage of the tumor can be determined by performing a thyroid scintigraphy. Similar information can be obtained after undergoing computed tomography.

To clarify the size of the tumor and the number of nodes, you can use ultrasound diagnostics. However, this study will not provide information about the nature of the oncological process.

An MRI scan allows you to identify a benign or malignant tumor in a patient. But the final confirmation of the diagnosis is impossible without a fine-needle biopsy of the thyroid gland with further histological examination of the resulting biopsy.

A blood test will reveal an increase in ESR, anemia. If a person has an elevated level of the hormone calcitonin in the blood, this allows one to suspect a medullary form of the tumor.

Thyroid tumor treatment

Treatment of a thyroid tumor depends on what form of the disease the person has and at what stage of development it is. It is possible, both independent and complex application of the following methods:

Operative intervention

Surgery is one of the leading treatments for thyroid cancer. It is not carried out only when an anaplastic formation is detected.

Cutting out one lobe of the thyroid gland is called a lobectomy. It can be carried out only if the tumor is small and does not go beyond the boundaries of the organ. The advantage of this procedure is that the patient does not need to take hormonal drugs in the future. After all, one lobe of the gland will remain with him, and it will function.

Thyroidectomy involves removing the entire organ. In this case, the patient will have to take thyroid hormones throughout his life, and this will need to be done daily. Most often, during the operation, the cervical lymph nodes are removed.

Radioactive iodine therapy

Treatment is based on the destructive effect on the glandular cells of the thyroid gland and tumors of radioactive iodine (Iodine-131). Once in the body, the drug is collected in the tissues of the gland and destroys the atypical tissue of the tumor. At the same time, other organs are not affected.

This method is used after surgery in order to destroy the remaining tissue and metastases.

It is especially effective to carry out treatment with radioactive iodine at stage 4 of a follicular or papillary tumor. To enhance the effect, the patient is prescribed a parallel administration of thyroid-stimulating hormone.

Treatment with hormonal drugs

Hormonal drugs may be prescribed to keep the body functioning normally and to prevent further growth of abnormal cells that may have remained after surgery.

Radiation therapy

Radiation therapy is used to treat anaplastic thyroid tumors. The impact is only on education itself. The course lasts for several weeks, 5 days a week. This reduces the risk of tumor recurrence after surgery, and also slows down the rate of maturation of metastases (if the tumor has grown into other tissues).

As for the prognosis, it is the most favorable, provided that the treatment was started in a timely manner and the tumor did not reach its maximum size. The least favorable prognosis for anaplastic tumors and lymphoma. The death of patients most often occurs within six months from the manifestation of the disease. An increased risk of metastasis is a medullary tumor, which sends atypical cells to distant organs.