Thyroid cancer in the elderly

Introduction

Introduction to thyroid cancer in the elderly Carcinoma of thyroid cancer (carcinoma ofthyroid) is a common malignant tumor of the head and neck, accounting for 1% to 2% of systemic malignant tumors, more common in women. The prognosis of thyroid cancer is better. Most thyroid cancers occur in young adults. Older people with thyroid cancer are rare, with high malignancy and poor prognosis. basic knowledge The proportion of illness: 0.0038% Susceptible people: the elderly Mode of infection: non-infectious Complications: nodular goiter

Cause

The cause of thyroid cancer in the elderly

Papillary carcinoma (20%):

It is a well-differentiated thyroid cancer, accounting for about 3/4 of the total. The side with more lesions has different tumor sizes. It is generally colorless and painless. It has poor swallowing activity, low malignancy and good prognosis.

Follicular carcinoma (15%):

It is also a well-differentiated thyroid cancer, accounting for 10% to 15%. The lesions are mostly single and there are multiple. The tumor is substantial, with colored membranes, tumors of different sizes, round or oval or knot. Jagged, slow growth, easy to be misdiagnosed as adenoma, more common in women 40 to 60 years old, individual with early blood transfer.

Medullary carcinoma (10%):

It is a cancer from the parafollicular cells of the thyroid gland. Some people call it parafollicular cell carcinoma or C-cell carcinoma, which accounts for about 5%. The tumor has no capsule, varies in size, and is mostly single. It is a moderately malignant thyroid cancer.

Undifferentiated cancer (5%):

Rarely, about 5%, most of the elderly male patients, highly malignant thyroid cancer, the prognosis is very poor, died within 1 year.

Pathogenesis

1. The cause of human thyroid cancer remains unclear. After the atomic bombing in Nagasaki and Hiroshima, the incidence of thyroid cancer in local residents increased. Some patients received radiotherapy in childhood, and the incidence of thyroid cancer increased. X-ray ratio 131I More carcinogenic, radioactive substances can cause thyroid cell gene mutations, and a considerable amount of cell death, secretion of thyroid hormone decreased, increased secretion of TSH, can promote cell proliferation and cause cancer.

2. Iodine deficiency can cause tumors in rats, and the incidence of thyroid tumors in endemic goiter areas is higher.

3. Some thyroid-causing substances, such as 2-acetylammonium, can act on thyroid tissue and cause thyroid tumors.

4. Familial tumor gene inheritance, thyroid cancer can occur, some patients with familial goiter, under the stimulation of TSH, a few people can develop cancer, thyroid cancer, medullary carcinoma, pheochromocytoma and digestive system tumors Have a family history.

5. In addition, different types of thyroid cancer have different causes. For example, papillary carcinoma is derived from follicular cell carcinoma, and its pathogenesis is related to long-term TSH, but it is not the original effect. TSH is only for papillary carcinoma. The growth has a certain effect, papillary carcinoma is more common in areas rich in iodide, and is definitely related to the role of radiation.

Prevention

Elderly thyroid cancer prevention

At present, the etiology and pathogenesis of thyroid cancer are still not very clear. Like other cancers, it is not good enough to prevent the disease, but should avoid or less exposure to radiation damage, normal iodine supplementation, improve environmental pollution, and cause less goiter. Large substances, families with genetic predisposition should be treated with gene therapy in the future, early diagnosis of thyroid cancer, early thorough treatment to prevent deterioration and metastasis, try to prevent viral infection, timely treatment of viral infectious diseases, such as subacute thyroiditis, etc. Exercise, enhance physical fitness, improve self-immunity, and prevent autoimmune diseases.

Complication

Elderly thyroid cancer complications Complications nodular goiter

The main complications are lung metastasis and bone metastasis.

Symptom

Elderly thyroid cancer symptoms Common symptoms Difficulty dysphagia Dysphagia nodules Parotid gland painless mass sounds hoarseness cool nodules old to thin

A painless mass of thyroid in the neck, single or multiple, hard, varying in size, recently growing rapidly, accompanied by difficulty swallowing, or hoarseness, poor activity, or lymph nodes in the side of the neck and swelling, young adults Women, elderly male patients, should be vigilant and consider the disease.

Examine

Examination of thyroid cancer in the elderly

Cytological examination: simple and accurate.

1. Ultrasound examination: B ultra-high frequency probe inspection is safe and convenient, and it is widely used.

2. CT and MRI: not only can check the size of thyroid tumor, but also understand the surrounding tissue, the relationship between mass and larynx, esophagus, trachea, lymph node metastasis, clear image, high accuracy.

3. Radionuclide E (ECT) examination: This examination has become a routine examination for the diagnosis of thyroid disease, usually with 131I and 99mTc (sorghum), and its cold nodules and cold nodules are suspected of thyroid cancer.

Because the pathological types of thyroid cancer are complex and biological characteristics are different, sometimes thyroid cancer is difficult to diagnose. In the operation, a quick freeze biopsy should be performed to confirm the diagnosis.

Diagnosis

Diagnosis and diagnosis of thyroid cancer in the elderly

The majority of neck thyroid masses are benign. Only about 10% of patients are thyroid cancer, mostly young and middle-aged women. The main benign thyroid diseases should be identified as follows:

The diagnosis of thyroid cancer can only be determined according to clinical manifestations. Comprehensive diagnosis should be made to confirm the diagnosis. The thyroid mass grows faster, there is metastasis, and there are obvious compression symptoms, hypothyroidism, thyroid scan cold nodules, or thyroid CT scan. And MRI images have abnormalities and metastasis, the final diagnosis should be based on pathological biopsy, clear thyroid papillary, follicular, undifferentiated or mixed cancer.

Differential diagnosis

1. Goiter: iodine-deficient goiter is endemic goiter, diffuse goiter, soft, malaise, edema, etc.

2. Thyroid cyst: often a single soft cystic mass, with good swallowing activity, no other accompanying symptoms.

3. Hyperthyroidism: more common in women around 35 years old, accompanied by hyperthyroidism, eating more, losing weight, protruding eyes, sweating more, glandular heart rate, blood pressure, irregular menstruation, diffuse thyroid, no Isolated nodules.

4. Subacute thyroiditis: more often due to an allergic reaction or infectious disease, thyroid enlargement is more uniform, no accompanying symptoms.

5. Thyroid tumors: mostly single, different in size, clear boundaries, good swallowing activity, smooth tumor, toughness, no infiltration symptoms, but if the thyroid mass increases rapidly in the near future, it should be vigilant, whether there is Malignant tendencies, early surgery, pathological examination, and clear diagnosis.

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