Prognosis Carcinoma thyroid

Q) Not an important prognostic factor in Carcinoma thyroid (JIPMER) 
A. Age
B. Completeness of resection
C. Multicentricity
D. Extra thyroid extension

Ans c

MOst of the papillary carcinoma are multicentric any way

As per AGES And AMES criteria.

HIgh risk - Male. Age more than 40 years, Size more than 4 cm, Capsular or extra thyroid extension, Regional or distant metastasis and poor differentiation

Low Risk - Well differentiated less than 2 cm. Age benefit is extended to 50 yrs in women

Ref ( Sabiston page page 903) 

IN younger patients (<45 years old), the presence of lymph node metastases had no effect on the excellent overall survival, but the presence of lymph node metastases increased the risk of death by 46% in patients older than 45

The presence of lymph node metastasis in patients with contained intrathyroidal primary papillary carcinoma also does not affect
long-term survival.

If there is gross or microscopic extension of a primary PTC through the thyroid capsule, a poor prognosis and
possibly a higher rate of lymph node metastasis may be anticipated.

Malignant features of salivary gland tumors

Q) What is not a clinical feature of malignant conversion of salivary gland tumor? 

a) Pain 

b) Facial nerve weakness

c) Swelling

d) Cervical lymph node swelling

Ans a

Clinical features of high-grade malignant salivary tumours include

1. facial nerve weakness

2. rapid enlargement of the swelling; 

3. induration and/or ulceration of the overlying skin;

4. cervical node enlargement.

Ref Bailey 27th page 783

Most of these tumors are painless

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