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Benign tumours

Benign tumours. Follicular adenoma(most common) Papillary adenoma (should be considered as malignant tumour ) Mesenchymal tumours ( lipoma , hemangioma ). Benign tumours. Clinically : solitary nodule . Investigation : U/S nodule. : RAIS hot or warm nodule.

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Benign tumours

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  1. Benign tumours • Follicular adenoma(most common) • Papillary adenoma (should be considered as malignant tumour) • Mesenchymaltumours (lipoma , hemangioma).

  2. Benign tumours Clinically : solitary nodule. Investigation : U/S nodule. : RAIS hot or warm nodule. Treatment by hemithyroidectomy.

  3. Malignant tumors.Classification • Primary : • From follicles • Differentiated: • Papillary 60% • Follicular 17% • Mixed • Undifferentiated : • Anaplastic carcinoma. • From parafollicular cells • Medullary carcinoma. • From interfollicular tissues • Lymphoma. • Sarcoma . • Secondary • Local spread. • Blood spread.

  4. Malignant tumors.Etiology : • Genetic (familial). • Hormonal (increased TSH). • Previous Irradiation . • Autoimmune thyroiditis. • On top of primary benign lesion.

  5. Malignant tumours.Clinical picture • Age : 2 beaks • 10 years and • 40-60 years. • Sex : females > males . • Gland : • Rapid rate of growth. • Hard or firm. • Less mobile or fixed. • Painless but painfull after infiltration.

  6. Malignant tumors.Clinical picture: • Cervical lymph nodes. • Pressure manifestation: • Dyspnea. • Dysphagia. • Change of voice. • Absent carotid pulsation. • Distant metastasis • Lung, liver. • Bone , brain.

  7. Malignant tumours.Investigations: • Routine. • Thyroid function. • Serum calcitonin. • Plain x-ray chest. • u/s neck, abdomen. • CT , MRI. • RAI scanning. • Biopsy: • FNAC • Operative biopsy.

  8. Malignant tumours.Treatment: • Total thyroidectomy. • Lymph nodes: • No LN  nothing. • Limited LN picking of LN. • Heavy LN modified radical neck dissection. • Adjuvant treatment: • RAI for follicular carcinoma. • Radiotherapy for anaplastic carcinoma. • Other tumors management: for medullary carcinoma.

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