thyroidcancer.pptVIP

Thyroid Cancerby Christopher Muller (MS4) UTMB Grand Rounds October 7, 1998 Faculty disscussants: Dr. Byron J. Bailey and Dr. Anna M. Pou Intoduction Consistent techniques of thyroid surgery date back approximately 100 years Theodor Kocher of Bern, Switzerland made major contibutions to thyroid the understanding of thyroid disease and thyroid surgery 1872 - performed his first thyroidectomy 1901 - had performed 2,000 thyroid procedure 1901 - overall operative mortality had decreased from 50% to 4.5% 1909 - won the nobel prize for his work (Cady, 1991, Soh,1996) Statistics of Thyroid Cancer 1.0%-1.5% of all new cancer cases in the United States (Sessions, 1993, Silverberg, 1989) ten fold less than that of lung, breast, or colorectal cancer 8,000-14,000 new cases diagnosed each year (Sessions, 1993, Geopfert, 1998) 3% of patients who die of other causes have occult thyroid cancer and 10% have microscopic cancers (Robbins, 1991) 35% of thyroid gland at autopsy in some studies have papillary carcinomas (1.0cm) (Mazzaferri, 1993) 1,000-1,200 patients in the U.S. die each year of thyroid cancer (Goldman, 1996) Statistics of Thyroid Cancer(continued…) 4%-7% of adults in North America have palpable thyroid nodules (Mazzaferri, 1993, Vander, 1968) 4:1 women to men (Mazzaferri, 1993) Overall, fewer than 5% of nodules are malignant (Mazzaferri, 1988) History  Symptoms The most common presentation of a thyroid nodule, benign or malignant, is a painless mass in the region of the thyroid gland (Goldman, 1996). Symptoms consistent with malignancy Pain dysphagia Stridor hemoptysis rapid enlargement hoarseness History (continued...) Risk factors Thyroid exposure to irradiation low or high dose external irradiation (40-50 Gy [4000-5000 rad]) especially in childhood for: large thymus, acne, enlarged ton