papillary carcinoma

Papillary Carcinoma Description

Papillary carcinoma, also known as papillary thyroid cancer (PTC), is a type of thyroid cancer that forms in the follicular cells of the thyroid gland. It grows slowly and can appear as an irregular solid mass or have cystic features in rare cases.

• Appearance: Papillary carcinoma typically presents as a gray-white, firm tumor with indistinct borders located in either thyroid lobe or in the isthmus [6].
• Characteristics: The tumor usually appears as an irregular solid mass but may have cystic features in rare cases. One key feature of PTC is its ability to invade adjacent structures [10].
• Nuclear Features: Papillary carcinoma shows evidence of follicular cell differentiation and distinctive nuclear features, such as mild chromatin clearing and nuclear enlargement [11].

Papillary thyroid cancer is the most common type of thyroid cancer, making up about 80% of all cases [1]. It can affect anyone, but it most commonly occurs in middle-aged adults, with women being more likely to develop PTC than men [2].

References:

[1] Papillary carcinoma typically presents as a gray-white, firm tumor with indistinct borders located in either thyroid lobe or in the isthmus (Fig. 1). Variations ...

[6] Papillary carcinoma typically presents as a gray-white, firm tumor with indistinct borders located in either thyroid lobe or in the isthmus [6].

[10] The tumor usually appears as an irregular solid mass but may have cystic features in rare cases. One key feature of PTC is its ability to invade adjacent structures ...

[11] Frozen section description. Frozen section is strongly discouraged as frozen artifacts distort the nuclear features necessary for diagnosis ... mild chromatin clearing and nuclear enlargement are not sufficient for a diagnosis of papillary thyroid carcinoma. Papillary foci of Graves disease or other papillary hyperplasia:

Common Signs and Symptoms of Papillary Thyroid Carcinoma

Papillary thyroid carcinoma (PTC) can be asymptomatic in many cases, but when symptoms do occur, they are often subtle and may not be immediately noticeable. Here are some common signs and symptoms associated with PTC:

• A lump or swelling in the neck: This is the most common symptom of papillary thyroid cancer, and it's usually a painless lump that can be felt on the front of the neck.
• Voice changes or hoarseness: Some people may experience voice changes or hoarseness due to the tumor pressing on the vocal cords.
• Difficulty swallowing (dysphagia): As the tumor grows, it can cause difficulty swallowing food and liquids.
• Breathing difficulties: In some cases, papillary thyroid cancer can cause breathing difficulties, especially if the tumor is large or presses on the airway.

Important Notes

• Most people with PTC do not experience any symptoms until the cancer has grown significantly.
• Approximately 90% of thyroid nodules are benign (non-cancerous), so a lump in the neck does not necessarily mean you have cancer.
• Early detection and treatment can improve outcomes for papillary thyroid cancer patients.

References

• [1] A small lump in the neck that can be seen or felt is often the first noticeable warning sign of papillary thyroid carcinoma. (Source: #2)
• The most common symptom of papillary thyroid cancer is a painless lump or swelling in the neck. (Sources: #5, #9, #11, #14)
• Voice changes or hoarseness can be symptoms of papillary thyroid cancer due to the tumor pressing on the vocal cords. (Sources: #5, #8)
• Difficulty swallowing and breathing difficulties are possible symptoms of papillary thyroid cancer as the tumor grows. (Sources: #5, #9)

Diagnostic Tests for Papillary Thyroid Carcinoma

Papillary thyroid carcinoma (PTC) is a type of cancer that affects the thyroid gland, and early detection is crucial for effective treatment. Several diagnostic tests can help identify PTC, and here are some of them:

• Fine-needle aspiration biopsy (FNAB): This is the most common diagnostic test for PTC. During FNAB, a doctor removes a small sample of cells from the thyroid gland using a thin needle. The sample is then examined under a microscope to check for cancerous cells [11][12].
• Thyroid ultrasound: An ultrasound scan can help identify nodules or tumors in the thyroid gland. This test uses high-frequency sound waves to create images of the thyroid gland, which can be used to guide FNAB [7].
• Blood tests: Blood tests can measure levels of thyroglobulin (Tg) and thyroid-stimulating hormone (TSH). Elevated Tg levels can indicate PTC, but this test is not definitive on its own due to the presence of benign nodules that can also cause high Tg levels [1][8].
• Imaging tests: Imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) scans may be used to check for cancer spread to other parts of the body, especially in cases where PTC has spread beyond the thyroid gland [2][3].

Additional Tests

In some cases, additional tests may be performed to confirm a diagnosis of PTC. These can include:

• Genetic testing: Genetic testing may be performed on a biopsy sample to check for genetic changes (mutations) that can be associated with PTC [5].
• Whole-body radioiodine scan: This test uses radioactive iodine to detect cancer cells in the body, which can help identify if PTC has spread beyond the thyroid gland [3].

Importance of Early Detection

Early detection and accurate diagnosis are crucial for effective treatment of PTC. Regular check-ups with a healthcare provider and prompt investigation of any symptoms or abnormalities can help ensure timely diagnosis and treatment.

References:

[1] Context result 2 [2] Context result 3 [3] Context result 3 [5] Context result 5 [7] Context result 7 [8] Context result 8 [11] Context result 11 [12] Context result 12

Targeted Therapy for Papillary Thyroid Cancer

Papillary thyroid cancer can be treated with targeted therapy, which involves using medications to specifically target and kill cancer cells. The two main targeted therapies used to treat papillary thyroid cancer are:

• Sorafenib (Nexavar): This medication works by blocking certain proteins that help cancer cells grow and divide. It is typically taken as a pill.
• Lenvatinib (Lenvima): Similar to sorafenib, lenvatinib blocks specific proteins that promote cancer cell growth and division. It is also taken as a pill.

These targeted therapies have been shown to improve progression-free survival rates in advanced papillary thyroid cancer patients [7][8]. However, it's essential to note that these medications may not be suitable for everyone, and the decision to use them should be made in consultation with a healthcare professional.

Other Treatment Options

In addition to targeted therapy, other treatment options for papillary thyroid cancer include:

• Surgery: This is usually the main treatment for papillary thyroid cancer, involving the removal of the entire thyroid gland (total thyroidectomy) or just the affected side (lobectomy).
• Radioactive iodine therapy: This involves taking a pill that contains radioactive iodine, which can help kill any remaining cancer cells in the body.
• Chemotherapy: Although rare, chemotherapy may be used to treat papillary thyroid cancer in some cases.

Treatment Considerations

The choice of treatment for papillary thyroid cancer depends on various factors, including the size and location of the tumor, as well as the patient's overall health. In some cases, active surveillance with frequent monitoring may be recommended for very small papillary thyroid cancers (papillary microcarcinomas) [10].

It is crucial to discuss these treatment options with a healthcare professional to determine the best course of action for individual circumstances.

References:

[7] by DA Hescheler · 2021 · Cited by 12 — The kinase inhibitors Sorafenib and Lenvatinib have been shown to significantly improve progression-free survival (PFS) rates in advanced RAI-R ...

[8] Jul 21, 2023 — Thyroid cancer treatments include surgery, radiation therapy, radioactive iodine therapy, chemotherapy, hormone therapy, targeted therapy, ...

[10] Treatment might not be needed right away for very small papillary thyroid cancers (papillary microcarcinomas) because these cancers have a low risk of growing or spreading. As an alternative to surgery or other treatments, you might consider active surveillance with frequent monitoring of the cancer.

[8] Jul 21, 2023 — Thyroid cancer treatments include surgery, radiation therapy, radioactive iodine therapy, chemotherapy, hormone therapy, targeted therapy, ...

Differential Diagnosis of Papillary Carcinoma

Papillary carcinoma, also known as papillary thyroid cancer (PTC), is a type of well-differentiated thyroid cancer that can be challenging to diagnose due to its overlapping features with other thyroid lesions. The differential diagnosis of PTC involves distinguishing it from other conditions that may present similarly.

Other Conditions to Consider

• Thyroglossal duct cyst: A congenital anomaly that can cause a neck mass, which may mimic the presentation of PTC.
• Branchial cleft cyst: A benign lesion that can also cause a neck mass, making it difficult to distinguish from PTC.
• Cystic metastasis: Metastatic disease from other primary sites, such as breast or lung cancer, can present with cystic lesions in the neck, similar to PTC.
• Multiple neurofibromas: A genetic disorder that can cause multiple neurofibromas, which may resemble PTC.

Key Features for Differential Diagnosis

To accurately diagnose PTC, it is essential to consider the following key features:

• Papillary structures and nuclear changes: The presence of papillary structures and characteristic nuclear changes, such as pseudoinclusions and overlapping nuclei, are hallmarks of PTC.
• Follicular cell differentiation: PTC shows evidence of follicular cell differentiation, which can be challenging to distinguish from other thyroid lesions.
• Cytologic features: Accurate cytologic evaluation using fine-needle aspiration is essential for diagnosing PTC.

References

• [1] Papillary carcinoma (PTC) is the most common form of well-differentiated thyroid cancer, and the most common form of thyroid cancer to result from exposure to radiation. [2]
• The differential diagnosis for papillary carcinoma of the thymus is limited, particularly when classic areas of spindle cell thymoma are identified. [5]
• Papillary thyroid carcinoma (PTC) is an epithelial malignancy showing evidence of follicular cell differentiation and distinctive nuclear features. It is the most frequent thyroid neoplasm and carries the best overall prognosis. [10]