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Total Thyroidectomy + Neck Lymphadenectomy

Thyroid Cancer

RARE

Cancer with GOOD PROGNOSIS


3 types of cancers :

1. Papillary Thyroid Cancer (90%)

2. Vesicular Cancer (10%), poor prognosis, Calcitonin marker assay recommended.

3. Anaplastic Cancer

Risk factor: radiation exposure.

DIAGNOSIS

– Often asymptomatic

– Medical examination: nodule palpation

– Imaging: ultrasounds + scintigraphy. Occasionally, a scan will also be necessary to eva-luate spread as well as compressive forms.

– Cytopuncture

TREATMENT

– Surgery: complete thyroidectomy + neck lymphadenectomy

– Postoperatively: radioactive iodine (RAI) therapy for 6 weeks, destruction of residual tumour tissue by radioactive iodine injection.

SURGICAL COMPLICATIONS

– Compressive cervical hematoma: vital emergency

– Recurrent impairment: lesion of one of the two recurrent nerves. Mostly leads to hoarse-ness and bitonality as well as choking. Complete recovery in 90% of cases.

– Treatment: vocal rehab sessions with a speech therapist

– Hypoparathyroidism:

Affects all 4 parathyroid glands
Clinically leads to disabling tingling feeling and asthenia.
Calcium treatment for life