Medullary carcinoma

produce calcitonin, amyloid is diagnostic, part of MEN II, FMTC(familial non-MEN medullary thyroid cancer), or sporadic cases.

Question: Treatment for medullary thyroid carcinoma?

Answer: Total with central node dissection

Question: Mutation associated with medullary thyroid carcinoma?

Answer: RET proto-oncogene

Hurthle Cell Carcinoma

Question: What is the management for Hurthle cell carcinoma?

Answer: <2cm then lobectomy adequate, if > 2cm than total

Follicular carcinoma

HEMATOGENOUS SPREAD

distinction between follicular adenoma and follicular carcinoma cannot be made on FNA or frozen section - NEED LOBECTOMY for DX

Question: management of follicular thyroid carcinoma?

Answer: if lobectomy is adenoma then stop, if follicular CA then total if > 1cm  (MRND if in nodes or out of thyroid tissue)

Papillary carcinoma

MOST COMMON, associated with prior neck irradiation and psammoma bodies, spreads to LYMPHATICS

Question: Surgery for papillary carcinoma?

Answer: Lobectomy for < 1cm, Total for > 1cm, multicentric, previous XRT, (MRND if in nodes or out of thyroid tissue) 

Question: What is lateral aberrant thyroid?

Answer: ectopic neck thyroid tissue that is usually metastatic papillary carcinoma