Most patients with PTC can expect an excellent prognosis, with the 10-year survival rate greater than 95% for the most favorable stages
Age at diagnosis is the most important prognostic factor in DTC. Diagnosis at an age younger than 40 years is associated with excellent survival.
(AMES or AGES) LOW RISK HIGH RISK
Age <40 years
Sex Female
Sabiston page 904
Q2. Chance of metastasis to lymph node in Papillary thyroid cancer a) <10% b) 10-20 c) 20-40 d) >60
Q3) Prophylactic thyroidectomy is done for
a) Medullary Carcinoma thyroid
b) Anaplastic
c) Lymphoma
d) Papillary Ca thyroid
ans a) Medullary carcinoma thyroid
Hereditary MTC is identified through germline RET mutation
When to do Prophylactic thyroidectomy
Children identified to harbor the ATA highest-risk RET mutations (i.e., Met918Thr) are recommended to undergo total thyroidectomy in the first year of life.
In children with ATA high-risk mutations (i.e., codon Cys634 and Ala883Phe mutations), prophylactic thyroidectomy is typically recommended before 5 years of age, with the exact timing based on annual clinical examination, neck ultrasound, and serum calcitonin levels starting from the age of 3 years
Children with ATA moderate-risk RETmutations, the timing of prophylactic thyroidectomy should be based on the findings of clinical examination, neck ultrasound, and serum calcitonin concentrations commencing at age 5 years.
Once calcitonin levels are greater than 30 pg/mL, the likelihood of nodal metastases increases, and this will often necessitate central node dissection, which is associated with increased operative morbidity and a reduction in duration of long-term remission.
Q4.Tumor suppressor gene involved in thyroid tumorigenesis
A. Braf
B. NTRK1
C.PTEN
4. RET
MEN 2b components are Medullary carcinoma of the thyroid; phaeochromocytoma; mucosal neuromas; ganglioneuromas of the gut Regular screening of blood pressure, serum calcitonin and urinary catecholamines;
Prophylactic thyroidectomy
Q5) Recurrent lymph node in neck after surgery for differentiated thyroid cancer. How to proceed a) Surgery again B) Radio iodine C) EBRt
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Q6) 40yr old lady 2X 2 Solitarty thyroid nodule left lobe. FNAC shows classic type of papillary carcinoma . Usg no neck nodes. Management
A. Total thyroidectomy B. Total thyroidectomy with Radio active Iodine C. Total thyroidectomy with central compartment neck dissection D. Hemithyroidectomy + follow up
Q7 Mc in thyroid malignancy A. Papillary carcinoma B. Follicular carcinoma C. Medullary carcinoma D. Anaplastic carcinoma