Papillary thyroid carcinoma

Other Names: Familial nonmedullary thyroid cancer, papillary; Nonmedullary thyroid carcinoma, papillary

Papillary thyroid carcinoma is a form of cancer that occurs due to abnormal and uncontrolled cell growth of certain cells (follicular cells) of the thyroid.

Causes

About 85% of all thyroid cancers diagnosed in the United States are the papillary carcinoma type. It is more common in women than in men. It may occur in childhood, but is most often seen in adults between ages 20 and 60. The cause of this cancer is unknown.

Risk factors

A genetic defect or family history of the disease may also be a risk factor. Radiation increases the risk of developing thyroid cancer. Exposure may occur from:

• High-dose external radiation treatments to the neck, especially during childhood, used to treat childhood cancer or some noncancerous childhood conditions
• Radiation exposure from nuclear plant disasters
• Radiation given through a vein (through an IV) during medical tests and treatments does not increase the risk of developing thyroid cancer.

Symptoms

Many people with papillary thyroid carcinoma have no signs or symptoms of the condition. When present, symptoms may include a small lump at the base of the neck, hoarseness, difficulty swallowing, trouble breathing, and pain in the neck or throat. Thyroid cancer often begins as a small lump (nodule) in the thyroid gland. While some small lumps may be cancer, most (90%) thyroid nodules are harmless and are not cancerous. Most of the time, there are no other symptoms.

Diagnosis

If you have a lump on your thyroid, your health care provider will order blood tests and possibly an ultrasound of the thyroid gland. If the ultrasound shows that the lump is less than 1 centimeter, a special procedure called a fine needle aspiration biopsy (FNAB) may be performed. This test helps determine if the lump is cancerous. CT scan of the neck may also be done to determine the size of the tumor. Thyroid function tests are often normal in people with thyroid cancer.

Treatment

There are three types of thyroid cancer treatment:

• Surgery
• Radioactive iodine
• Medicine

Surgery is done to remove as much of the cancer as possible. The bigger the lump, the more of the thyroid gland must be removed. Often, the entire gland is taken out.

After the surgery, you may receive radioiodine therapy, which is often taken by mouth. This substance kills any remaining thyroid tissue. It also helps make medical images clearer, so doctors can see if there is any cancer left behind or if it comes back later.

If surgery is not an option, external radiation therapy can be useful.

After surgery or radioiodine therapy, you will need to take medicine called levothyroxine for the rest of your life. This replaces the hormone the thyroid would normally make.

Your provider will likely have you take a blood test every several months to check thyroid hormone levels. Other follow-up tests that may be done after treatment for thyroid cancer include:

Ultrasound of the thyroid An imaging test called a radioactive iodine (I-131) uptake scan Repeat FNAB The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.

• Lenvatinib (Brand name: Lenvima)Treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine refractory differentiated thyroid cancer.

Prognosis

The survival rate for papillary thyroid cancer is excellent. More than 90% of adults with this cancer survive at least 10 to 20 years. The prognosis is better for people who are younger than 40 and for those with smaller tumors.

The following factors may decrease the survival rate:

• Older than 55
• Cancer that has spread to distant parts of the body
• Cancer that has spread to soft tissue
• Large tumor

NIH genetic and rare disease info

• NIH info on Papillary thyroid carcinoma

Papillary thyroid carcinoma is a rare disease.

Papillary thyroid carcinoma Resources
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Papillary thyroid carcinoma Resources
Latest articles Most recent articles Ongoing trials	Wikipedia