Five main types of Thyroid Cancer

1. Papillary Carcinoma (80%)
2. Follicular Carcinoma (10%)
3. Medullary Carcinoma (5%)
4. Hurthle Cell Carcinoma (4%)
5. Anaplastic/Undifferentiated Carcinoma (1-2%)

P’s of Papillary Thyroid Cancer:

• Popular (most common type – 80%)
• Psammoma bodies
• Palpable Lymph Nodes – common
• Positive Iodine 131 uptake
• Positive Prognosis
• Postoperative Iodine 131 to diagnose / treat metastasis if a total thyroidectomy was done.

F’s of Follicular Cancer of the Thyroid

• Far away metastasis (spreads hematogenously)
• FNA NOT (FNA cannot be done to diagnosis Follicular Cancer of the thyroid
• Female predominance (3:1)

M’s of Medullary Cancer of the Thyroid

• MEN II (Multiple Endocrine Neoplasia type II)
• aMyloid
• Median Lymph Node dissection
• Modified neck dissection if lateral nodes are positive

• Secretes Calcitonin
• Stimulated by Pentagastrin
• Cancer of the Thyroid C cells = parafollicular cells

Calcitonin (tumor marker for MTC)

• Reduces blood levels of Calcium
• Opposed the effects of PTH (parathyroid hormone)
• Calcitonin is used as a tumor marker for medullary thyroid cancer (MTC)

Pentagastrin

• Pentagastrin has effects like gastrin
• Pentagastrin is used as a stimulation test to elevate serotonin levels and cause symptoms of carcinoid syndrome, provoking flushing.
• Pentagastrin has been used to stimulate ectopic gastric mucosa for the detection of Meckels diverticulum by nuclear medicine.
• Pentagastrin-stimulated calcitonin test is a diagnostic test for MTC (Medullary carcinoma of the thyroid).  In patients with suspected MTC but borderline levels of calcitonin, injecting pentagastrin will cause calcitonin levels to rise tremendously.

Picture from: http://www.washingtonendocrineclinic.com/Thyroid-Care.html