Diagnosis and Prognosis of Thyroid Cancer
Review of Medical History
- Thyroglobulin—best blood test for papillary and follicular cancers
- PET proto-oncogene—test for those with known or suspected medullary cancer
- CT scan
- MRI scan
- Radioactive iodine uptake (RAIU) test – A radioactive substance called a tracer (usually iodine or technetium) is taken in either a liquid or capsule. It is absorbed by the thyroid gland from the bloodstream. Then, a special probe measures the amount of radioactive substance absorbed by the thyroid gland. The amount of uptake can help diagnose thyroid abnormalities.
- Radioactive octreotide scan—A radioactively tagged hormone called somatostatin is given. This hormone attaches to certain tumors because—compared with normal, noncancerous tissue—many neuroendocrine tumors have much higher concentrations of somatostatin receptors. After the hormone is given, a special machine is used to recognize the radioisotope and produce a hot spot where the tumor is located.
- TX: Tumor cannot be evaluated.
- T0: There is no evidence of tumor.
- T1: Thyroid tumor is 2 centimeters (cm) or less.
- T2: Thyroid tumor is 2 cm to 4 cm, and within the thyroid.
- T3: The thyroid tumor is larger than 4 cm and within the thyroid, or any tumor that has minimal extension outside of the thyroid.
The thyroid tumor has spread beyond the thyroid and involves other neighboring tissues within the neck. All anaplastic thyroid cancers are considered T4 tumors. Tumors may be divided to T4a and T4b.
Note: All anaplastic thyroid cancers are considered T4 tumors, with T4a being surgically resectable and T4b being surgically unresectable.
- T4a: This refers to a thyroid tumor regardless of size, which extends beyond the capsule surrounding the thyroid gland invading the esophagus, trachea, and larynx .
- T4b: The thyroid tumor invades blood vessels (the carotid artery or blood vessels in chest) and the covering around the vertebrae.
- NX: Nodes cannot be evaluated.
- N0: There are no cancer cells in the regional lymph nodes.
- N1: There are cancer cells in lymph nodes of the neck (cervical lymph nodes) or upper chest (upper mediastinal lymph nodes). N1 nodes may be divided to N1a and N1b, depending on the distance from the thyroid.
- MX: Presence of metastasis cannot be evaluated.
- M0: There is no distant metastasis.
- M1: There is distant metastasis, such as to distant lymph nodes, liver, lungs, and/or brain.
- T3, N0, M0
- T1-3, N1a, M0
- T4a, N0-N1a, M0
- T1-4a, N1, M0
- T4b, any N, M0
- T1-4, any N, M1
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What is thyroid cancer. American Cancer Society website. Available at http://www.cancer.org/docroot/CRI/CRI%5F2%5F3x.asp?dt=43 . Accessed December 10, 2002.
What you need to know about cancer of the thyroid. National Cancer Institute website. Available at http://cancer.gov/ . Accessed December 10, 2002.
- Reviewer: Mohei Abouzied, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -
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