Many patients are diagnosed each year with a tumor in the thyroid gland. Most thyroid tumors are treatable, especially if diagnosed early on. Very few tumors types are still difficult to treat. This is a page of information on thyroid tumors and their management
Structure and function of thyroid gland
The thyroid gland is located at the anterior lower part of the neck. The gland is divided into two lobes and another part connects them and is called Isthmus.
The gland secretes hormones, the most important of which are thyroxine (T4) and thiroidoterinine (T3). These hormones affect the body's metabolic rate, the rate of growth, tissue regeneration and functioning of many systems in the body.
The parathyroid glands are located behind the thyroid gland (usually 4 glands), and their function is to produce a hormone that regulates calcium levels in the body.
Near each lobe of the thyroid is a nerve that is responsible for innervation- movement of vocal cords.
The first sign of thyroid tumor in most cases is a small lump that is not painful in the gland. At the same time, it is important to clarify that the thyroid lumps is very common in adults and most of them are not cancerous.
Thyroid tumors can be in one or both lobes. There are 5 types of malignant tumors. The most common type is Papillary and accounts for 75% of all thyroid tumors. In the papillary type, the cure rate is very high.
The other types are: follicular, Hurthle cell, medullary, anaplastic. They have less favorable prognosis.
A final diagnosis of the tumor is made after a biopsy is taken from the suspected lump. In this procedure, a delicate needle is inserted through the skin into the suspected thyroid gland tumor and cells and fluid are being collected. This is called - Fine Needle Aspiration, FNA. Sometimes done under Ultra Sound (US). This is generally considered a painless procedure.
The material extracted from FNA is sent to the pathology laboratory, and the pathologist examines the cells under a microscope. A final answer is received about a week later. Depending on your biopsy answer, your doctor will explain what treatment options are right for you. When the pathology's response is malignancy or high suspicion of malignancy, it is recommended that surgery be done for the removal of one lobe or the entire thyroid gland.
Other tests that may be required are the level of calcitonin, which can be high in the medullary tumor type. Rarely there is a need to undergo additional tests to assess the extent of the tumor and whether the tumor has spread to the lymph nodes of the neck or distant organs.
Examples will include computer tomography (CT) ,(MRI) and PET CT.
Complete / partial thyroid surgery (THYROIDECTOMY)
Surgery is the treatment of choice in the most thyroid tumors. The surgery will be performed by surgeons who specialize in thyroid surgery with an experience of hundreds of surgeries.
The surgery is performed through an incision in the anterior lower part of the neck. Depending on the size of the tumor and its spread, the patient may also undergo a neck dissection to remove lymph nodes and fatty tissue that may be infected with malignant cells. Before surgery, and sometimes during surgery, the surgeon will examine the thyroid gland and decide how much volume to take out. If you remove half the gland, the surgery is called a partial thyroidectomy. If the entire gland is removed, the surgery is called total thyroidectomy. The surgery lasts about two hours, and if the neck dissection is performed, the surgery length is extended.