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Solitary Thyroid Nodules (Malignant (Anaplastic (Rare, F>M = 3:1, age…
Solitary Thyroid Nodules
Malignant
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Anaplastic
Rare, F>M = 3:1, age over 60
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Rapid growth
Aggressive: local,
LN and blood.
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Papillary
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spread to Nodes and lung
- JDG node = lateral aberrant thyroid
May be multifocal
Tx
Total thyroidectomy +
T4 to suppress TSH
± node excision
± radioiodine
95% 10ys
Follicular
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Tx
Total thyroidectomy +
T4 suppression +
Radioiodine
95% 10ys
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Benign
Follicular Adenoma
2-4cm mass
± thyrotoxicosis
Indistinguishable from follicular Ca on FNAC
- need excision histology to confirm Dx
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Thyroid Cyst
True cysts are rare
Mostly colloid degeneration, necrosis or
haemorrhage w/i benign or malignant tumours
Only benign if abolished by aspiration
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Practicalities of Thyroid Surgery
Render euthyroid pre-op w/ antithyroid drugs
Stop 10 days prior to surgery (they ↑ vascularity)
Alternatively just give propranolol
Check for phaeo pre-op in medullary carcinoma
Laryngoscopy: check vocal cords pre- and post-op
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