thyroid甲状腺癌全英文简版

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2015-4-16

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2015-4-16
THYROID CANCER
1 where is it？ ANATOMY
2 why did it happen？
ETIOLOGY
3 what to do with it?
TREATMENT
4
2015-4-16
HOW BAD IS IT?
PROGNOSIS
femal (over 60 or under 30).
❷ Symptom ＆Sign:painless ;small and hard and fixed
solitary nodule;rapid growth(Ominous sign).
❸ Accessory examination：calcification;enlargement of neck lymph nodes.
The surgical methods differ from cancer types and lymphatic metastasis .
surgical method
Type of cancer cell
Lymphatic metastasis
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2015-4-16

THYROID ANATOMY
③
3.Nerves and vessels (both coupled): ①2 nerves :superior laryngeal nerve + recurrent laryngeal nerve. ②2 arterys:superior and inferior thyroid arterys ③3 veins:superior 、 middle and inferior thyroid veins. 4.Lymphatic drainage: knowing the way how throid cancer cell transfers is the foundation to lymphadenectomy .
2015-4-16

THYROID CANCER
1 where is it？ ANATOMY
2 why did it happen？
ETIOLOGY
3 what to do with it?
TREATMENT
4 HOW BAD IS IT?
2015-4-16
PROGNOSIS
Staging ＆Prognosis
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Staging ＆Prognosis
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Staging ＆Prognosis
T1a T1b
T2
T3
2015-4-16

Thyroid Cancer
Shuguang Hospital General Surgery VINCENT Rao

THYROID CANCER
1 where is it？
2
why did it happen？
ANATOMY
ETIOLOGY
3 what to do with it?
2.Gold standard:pathological examination( fineneedle aspiration biopsy (FNAB)).
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Diagnosis＆Treatment
Treatment Let General Surgeons do their jobs.

Diagnosis＆Treatment DIGNOSIS: 1.Any throid mass having the following conditions should be considered malignant.
❶General condition ：children(50%) ;male(increased rate);
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Diagram of cervical lymph node levels
• Level IA : bounded by anterior belly and hyoid bone. • Level IB : bounded by the anterior and posterior bellies and the mandible.
Level VI (Central compartment lymph nodes):bounded by hyoid
bone , the common carotid arteries and the sternum .Although level VI is large in area, the few lymph nodes that it contains are mostly in the paratracheal regions near the thyroid gland. • Level VII:superior mediastinum lymph nodes.
Diagnosis＆Treatment
Central lymph node dissection
Thyroidectomy
＋
functional neck dissection
modified radical neck dissection(MRND)
radical neck dissection(RND)
③
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THYROID ANATOMY
③
④From skin to thyroid： skin → superficial fascia （platysma） → superficial layer of deep fascia → infrahyoid muscles → Pretracheal fascia → thyroid
•
•
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lymph node metastases of Thyroid cancer
• • • • • •
Study shows that : VI is often the first level >>>>> The second is level III、IV >>>>> Level VII、II、V、I is not frequent .
2015-4-16
Diagram of cervical lymph node levels
• • Level V： posterior triangle of neck Level II: bounded by skull base, stylohyoid muscle, hyoid bone horizontal line and posterior edge of the sternocleidomastoid muscle. Level III :begins at the inferior edge of level II and is bounded by the laryngeal strap muscles anteriorly, by the posterior border of the sternocleidomastoid muscle posteriorly, and by a horizontal plane extending posteriorly from the inferior border of the cricoid cartilage. Level IV :begins at the inferior border of level III and is bounded anteriorly by the strap muscles, posteriorly by the posterior edge of the sternocleidomastoid muscle, and inferiorly by the clavicle.
TREATMENT
4
2015-4-16
HOW BAD IS IT?
PROGNOSIS

THYROID ANATOMY
1.Apperance: the largest endocrine glands:butterflyshaped of two side lobes connected by isthmus . 2.Location: ①below the thyroid cartilage,around larynx and trachea。 ② 5 cm long, 3 cm wide and 2 cm thick。 ③top to the middle of thyroid cartilage ,down to the fifth or sixth tracheal ring。
Staging ＆Prognosi-16

Staging ＆Prognosis
M1
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Staging ＆Prognosis
2015-4-16

2015-4-16
THYROID CANCER
1 where is it？
ANATOMY
2 why did it happen？
ETIOLOGY
3 what to do with it?
TREATMENT
4
2015-4-16
HOW BAD IS IT?
PROGNOSIS

ETIOLOGY
Based on classification :
• Papillary thyroid cancer (75% to 85% of cases ) – often in young females – excellent prognosis. relevant to radiotherapy ,TSH,excessive iodine intake. • Follicular thyroid cancer (10% to 20% of cases ) – occasionally seen in patients with Cowden syndrome.relevant to iodine deficiency. • Medullary thyroid cancer (5%[10] to 8% of cases) – cancer of the parafollicular cells,relevant to gene. • Anaplastic thyroid cancer (Less than 5%[10]) –It is not responsive to treatment and can cause pressure symptoms,could DIE quickly.