The thyroid is an endocrine gland located in the middle of the neck, in front of the trachea and above the sternal notch. This gland, through the production of hormones, controls our body’s metabolism.
Thyroid cancer (cancer is a rare malignancy. It affects approximately 2% of all tumors; it occurs primarily between the ages of 25 and 60 and is more common in women. Survival is very high, exceeding 90% in differentiated forms.
If you are experiencing symptoms or have been diagnosed with a thyroid condition, consulting the Best ENT Surgeon Near Me can ensure an accurate diagnosis and expert treatment tailored to your needs.
Types of thyroid cancer
Cancers that affect the gland are called adenocarcinomas.
In the case of the thyroid, papillary adenocarcinoma can occur, which is the most frequent histological type and can be found in its various variants, with a more or less aggressive nature, but always belonging to a differentiated tumor form, together with the follicular histological type.
Then there are tumor forms affecting the parafollicular cells, called medullary thyroid carcinoma. A very aggressive, but fortunately very rare, type of neoplasm is anaplastic thyroid carcinoma, which develops distant metastases within a very short time.
In other cases, we speak of tumors of lymphatic origin (lymphomas) or of muscle tissue (sarcomas) or, finally, metastatic tumors, which originate from other organs.
Diagnostic tests
To diagnose thyroid cancer, several tests are necessary:
- THYROID ULTRASOUND: This test plays a key role in diagnostics as it is easily repeatable and, above all, non-invasive. The ultrasound identifies, in addition to the morphology of the gland’s nodules, the possible presence of adjacent suspicious lymph nodes.
- THYROID SCINTIGRAPHY: This test distinguishes between “hot” and “cold” nodules. “Hot” nodules have a very low risk of malignancy. “Cold” nodules, on the other hand, present a higher risk.
- LARYNGEAL FIBROLARYNGOSCOPY: This test is performed by an ENT specialist to assess vocal cord mobility, which is important both before and after thyroid surgery. It allows for the assessment of possible damage to the recurrent nerve, a branch of the vagus nerve that travels to the gland and controls vocal cord mobility.
- -CYTOMORPHOLOGICAL INVESTIGATIONS: for this test, performed under ultrasound guidance, a thin needle is used to aspirate the material to be analyzed, the result of which becomes decisive in the therapeutic conduct(surgery versus medical therapy) and is indicated by a TIR acronym on an increasing scale according to the severity of the condition (from 1 – not significant to 5 – frankly malignant).
Thyroid cancer treatment
Surgery is the most effective treatment for thyroid cancer. A small papillary or follicular carcinoma can be treated with conservative surgery, with removal of only the affected side, in selected cases.
Total thyroidectomy is typically the gold standard treatment.
The affected lymph nodes are obviously removed, while the opportunity to remove them for preventive purposes is evaluated in cases in which the tumor pathology (differentiated papillary forms) affecting the gland is of a certain size or goes beyond the boundaries of the gland, as well as in cases of medullary carcinomas.
In cases of differentiated tumor forms, of significant size or with metastases both at the lymph node level and at distant sites, post-operative radiometabolic therapy with iodine-131 is performed.
Traditional radiotherapy and chemotherapy are used only in dedifferentiated forms or in selected cases.
Thyroid cancer prognosis
The prognosis of thyroid cancer is greatly influenced by prognostic factors such as age, the presence of distant metastases, histotype (differentiated from de-differentiated forms), and currently genetic markers (e.g., B-raf mutation), which not only guide the choice of multimodal therapy, but may also be used in the future as targets for pharmacological therapies.
The role of the ENT specialist in diagnosis
The ear, nose, and throat specialist has a vast knowledge of the anatomy of the neck, not just the thyroid.
He is essential in the diagnosis and treatment of more complex neoplasms, affecting the tissues surrounding the thyroid and the lymph nodes of the neck, as well as a competent figure in the management of possible complications of thyroidectomy surgery (dysphonia, dyspnea).
It is important to contact hospitals that have an ENT and Head and Neck Surgery department equipped with the most modern diagnostic and surgical technologies for the diagnosis and treatment of head and neck tumors.