Papillary Thyroid Cancer

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The most common type of cancer is papillary thyroid cancer, occurring in more than 75% of cases. Typically, such a tumor arises from a healthy thyroid tissue and shows itself as a neoplasm in the form of a cyst or an uneven, solid tumor. Papillary cancer can be considered one of the most treatable types of malignant tumors. In 85% of cases, cancer patients are cured completely from this type of cancer.

In comparison with other types of oncological neoplasms, papillary thyroid cancer is characterized by a fairly long development. In addition, such cancer practically does not cause the appearance of metastases in other organs. Most often, the appearance of metastases affects the lymph nodes, since they are in close proximity to the gland.

Symptoms.
Progressing papillary cancer for quite a long time, which is why in the first stages of the disease there are practically no symptoms. The patient does not feel any pain, nor any other disturbing signs. The most common and first symptom is the formation of painful seals in the neck. In addition, the patient can feel the following:

The emergence of nodes and seals in the neck;
Increased cervical lymph node;
The onset of pain in the thyroid gland;
Difficulty in inhaling / exhaling and swallowing;
A change of voice is possible.
Causes of a tumor on the thyroid gland

Modern medicine does not have precise and proven causes of tumors on the thyroid gland, in particular papillary cancer. The most likely cause is a cell mutation at the DNA level. The causes of mutations are also not known.

The cellular structure of the thyroid gland forms tumors after cell mutations that begin to actively grow. The growth of malignant cells occurs gradually, affecting healthy organ tissues. According to doctors, papillary thyroid cancer can occur for the following reasons:

Iodine deficiency in the human body;
Congenital factor;
Influence of the environment, poor ecology;

Clinical picture.
The most frequent manifestation of a malignant disease is the appearance of a node or compaction in the thyroid gland. Usually papillary cancer has a single location, but there are multiple organ damage. As a rule, the seals have a dense structure. Nodes that are located deep beneath the tissues of the healthy gland, in some cases can not be palpable.

Neoplasms up to 1 centimeter in diameter may not be detected when examined by a doctor and palpation of the gland, and manifest themselves after metastasizing to the lymph node. Small neoplasms are called as latent papillary thyroid cancer. This type of tumor has a favorable course even during metastasis. Usually, the tumor can move freely in the organ and shift when swallowed. However, in cases where the papillary cancer sprouts in the adjacent organs, the tumor becomes stable and does not move.

Metastases of papillary cancer, formed in the lymph nodes, remain encapsulated for a long period of time. They very rarely affect the surrounding organs and tissues. Such metastases can be in the body for many years and not how to not show oneself. 65% of patients develop metastasis in the lymph nodes. At the same time, metastasis to another thyroid gland was seen only in 25% of patients. Extremely rare metastases appear in the bones and lungs. The course of the disease is characterized by the preservation of thyroid gland function.

Pathological anatomy.
Malignant formations and nodes can be as large as 0.1 to 5 centimeters in diameter, in some cases even larger. Usually tumors do not have a membrane and consist of branches diverging in different directions. The new formation is covered with a special kind of epithelium, which in diameter is equal to 25 microns and has a large nucleus. Inside it is filled with delicate chromatin cells. In addition, there can be separate stems without vessels, which are covered with non-viable epithelium. Papillary tumor formation can be characterized by the presence of special bodies, consisting of a separate type of tissue. In the central part of the tumor, scar tissue with calcium deposition can be observed. As a rule, the papillary malignant neoplasm has a mixed structure of the structure.

Cancer of the thyroid gland metastasizes by movement through the canals of the organ and passage into the lymph nodes. Metastases that are distant from the gland are rare. Follicular impregnations of malignant papillary formation and its metastasis of identical structure are usually able to absorb radioactive iodine and are characterized as active. Rare and occurring from the follicular parts of the formation is inactive and unable to absorb radioactive iodine.

The course of the disease and possible predictions.

Papillary thyroid cancer is characterized by an extremely favorable course. Even with the detection of metastases in the lymph node, patients can live for a very long time. After the surgical intervention the patient can live more than 5 years in 96% of cases, more than 10 years – in 88%, more than 15 years – in 76% of cases.

If metastasis occurs in bone tissue and respiratory system, the prognosis may be worse. But this is not a verdict. With effective treatment, patients experience prolonged remissions or an absolute cure. The lethal outcome of thyroid cancer in those under the age of 50 is very rare.

Diagnosis of the disease.
Primary diagnosis of a malignant tumor in the thyroid gland can be performed by a doctor by palpating the cervical region. When there are seals and patient’s nodes, they are sent for ultrasound examination. However, the final and accurate diagnosis can be made only after a histological analysis of the node, cut from the gland or the removed lymph node. The detection of metastases in bone tissue and lungs is carried out using an X-ray study.

If there are small tumors that are not probed, there may be difficulties in diagnosing the disease, since the increase in lymph nodes in the cervical region indicates a number of other diseases. To confirm or disprove the papillary thyroid cancer, a histological analysis of the cut off lymph node is performed.

Treatment.

Modern medicine has in its arsenal an effective method of treating thyroid cancer, which consists of two stages:

Operative intervention of surgeons;
Carrying out procedures with radioactive iodine.

At the first stage of treatment, a surgical operation is performed to cut off the sick cells of the organs or complete excision of the thyroid gland. When a number of lymph nodes are afflicted, complete or partial removal of lymph nodes in the cervical region is performed. Statistics indicate that papillary cancer most often affects the lymph nodes located near the larynx and trachea.

At the second stage of treatment, procedures are performed with radioactive iodine. Such treatment is indicated for patients with a malignant tumor and the presence of metastases in the lymph nodes, as well as with the growth of malignant formations through the membrane of the organ. Cells that have escaped from the gland are very dangerous. Therapy with radioactive iodine kills cancer cells left after surgery. Usually, tumor cells can remain in the thyroid itself. In addition, radioactive iodine effectively fights with metastases located in the lungs, the lymphatic system.

Rehabilitation Therapy.

After the surgical intervention and therapy with radioactive iodine, the doctor must necessarily assign a complete diagnosis of the patient’s health. Such a survey makes it possible to establish all cancer locations or confirm a successful cure.

Based on the findings, the doctor prescribes a substitution therapy consisting of the introduction of a synthetic analogue of the thyroid hormone thyroxine. The hormone preparation has an identical structure of natural hormone. This is necessary to meet the needs of the body.

After the patient is discharged for home stay, a systematic visit to the endocrinologist is necessary to diagnose the general health after the operation. To papillary thyroid cancer or its relapses were found on time, it is necessary to undergo a general examination once a year. The examination should include blood tests to determine the level of thyroid-stimulating hormone, the presence of a free fraction of thyroxine, the degree of therio-globulin and antibodies to it. These tests indicate the sufficiency or insufficiency of the substitution therapy prescribed for the patient, and the level of thyroid globulin indicates the presence or absence of a recurrent course of the disease. If the degree of therio-globulin is low, then this indicates the absence of malignant neoplasms. The high degree of presence of therio-globulin in the blood indicates the presence of metastases in the human body. In this case, additional diagnostic tests are performed.

In addition to blood tests for hormones, it is important to undergo an ultrasound examination of the thyroid gland and lymph nodes located in the cervical region. It is also important to undergo a full body scan with iodine-123.

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