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THYROID MALIGNANCY
CLINICAL FEATURES
NEETHI.T.P
ROLL NO: 29
PAPILLARY CARCINOMA OF THYROID
CLINICAL FEATUTES
• Thyroid swelling – soft or firm or hard
solid or cystic
solitary or multinodular

• Compression features are uncommon
• Often descrete lymphnodes in the neck (40%) are
palpable
• This may present with secondaries in neck
lymphnodes with occult primary
FOLLICULAR CARCINOMA
CLINICAL FEATURES
• Swelling in the neck- firm or hard and nodular

• Tracheal compression/ infiltration & stridor
• Dyspnoea, haemoptysis, chest pain when
there are lung secondaries
• Hoarseness of voice if recurrent laryngeal
nerve involvement occurs
• Absence of carotid pulsation, if lesion infiltrate
into carotid sheath (positive berry’s sign)
• Pulsatile secondaries in skull and longbones
CLINICAL SCORING SYSTEMS
• AMES clinical scoring system
Based on Age
distant Metastasis
Extent of primary tumour
Size of primary tumour
• AGES clinical scoring system
Based on Age
pathologic Grade of the tumour
Extent of the tumour
Size of the tumour
Prgnostic risk classification for patients
based on AMES or AGES
Risk
parameter

LOW

HIGH

age

<40

>40

gender

female

male

extent

No local extension,
intrathyroidal, no capsular
invasion

Capsular invasion,
extrathyroidal extension

metastasis

none

Regional or distant

size

<2 cm

>4 cm

grade

Well differentiated

Poorly differentiated
ANAPLASTIC CARCINOMA
CLINICAL FEATURES

• Swelling in thyroid region- rapidly progressive
hard with involvement of isthmus and lateral
lobes
• Stridor and hoarseness of voice due to
tracheal obstruction
• Dysphagia
• Fixity to the skin
• Positive berry’s sign
MEDULLARY CARCINOMA
CLINICAL FEATURES
• Thyroid swelling often with enlargement of neck
nodes
• Diarrhoea, flushing (30 %)

• Hypertension, pheochromocytoma, and mucosal
neuromas when associated with MEN II syndrome
• Sporadic and familial types occur in adulthood
• Cases associated with MEN II syndrome occur
in younger age group
• Paraneoplastic syndrome like cushing’s,
carcinoids may be present.
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Clinical features of thyroid malignancy

  • 2. PAPILLARY CARCINOMA OF THYROID CLINICAL FEATUTES • Thyroid swelling – soft or firm or hard solid or cystic solitary or multinodular • Compression features are uncommon • Often descrete lymphnodes in the neck (40%) are palpable • This may present with secondaries in neck lymphnodes with occult primary
  • 3. FOLLICULAR CARCINOMA CLINICAL FEATURES • Swelling in the neck- firm or hard and nodular • Tracheal compression/ infiltration & stridor • Dyspnoea, haemoptysis, chest pain when there are lung secondaries
  • 4.
  • 5. • Hoarseness of voice if recurrent laryngeal nerve involvement occurs • Absence of carotid pulsation, if lesion infiltrate into carotid sheath (positive berry’s sign) • Pulsatile secondaries in skull and longbones
  • 6.
  • 7.
  • 8. CLINICAL SCORING SYSTEMS • AMES clinical scoring system Based on Age distant Metastasis Extent of primary tumour Size of primary tumour
  • 9. • AGES clinical scoring system Based on Age pathologic Grade of the tumour Extent of the tumour Size of the tumour
  • 10. Prgnostic risk classification for patients based on AMES or AGES Risk parameter LOW HIGH age <40 >40 gender female male extent No local extension, intrathyroidal, no capsular invasion Capsular invasion, extrathyroidal extension metastasis none Regional or distant size <2 cm >4 cm grade Well differentiated Poorly differentiated
  • 11. ANAPLASTIC CARCINOMA CLINICAL FEATURES • Swelling in thyroid region- rapidly progressive hard with involvement of isthmus and lateral lobes • Stridor and hoarseness of voice due to tracheal obstruction • Dysphagia • Fixity to the skin • Positive berry’s sign
  • 12.
  • 13.
  • 14. MEDULLARY CARCINOMA CLINICAL FEATURES • Thyroid swelling often with enlargement of neck nodes • Diarrhoea, flushing (30 %) • Hypertension, pheochromocytoma, and mucosal neuromas when associated with MEN II syndrome
  • 15. • Sporadic and familial types occur in adulthood • Cases associated with MEN II syndrome occur in younger age group • Paraneoplastic syndrome like cushing’s, carcinoids may be present.