thyroi甲状腺癌全英文简版.pptVIP

THYROID CANCER 1.Apperance: the largest endocrine glands:butterfly-shaped of two side lobes connected by isthmus .2.Location:①below the thyroid cartilage,around larynx and trachea。② 5 cm long, 3 cm wide and 2 cm thick。③top to the middle of thyroid cartilage ,down to the fifth or sixth tracheal ring。 ④From skin to thyroid：skin→ superficial fascia（platysma）→ superficial layer of deep fascia →infrahyoid muscles→Pretracheal fascia→thyroid 3.Nerves and vessels (both coupled):①2 nerves :superior laryngeal nerve + recurrent laryngeal nerve.②2 arterys:superior and inferior thyroid arterys③3 veins:superior 、middle and inferior thyroid veins.4.Lymphatic drainage: knowing the way how throid cancer cell transfers is the foundation to lymphadenectomy . Diagram of cervical lymph node levels Diagram of cervical lymph node levels lymph node metastases of Thyroid cancer Study shows that : VI is often the first level The second is level III、IV Level VII、II、V、I is not frequent . THYROID CANCER ETIOLOGY Based on classification : Papillary thyroid cancer (75% to 85% of cases ) – often in young females – excellent prognosis. relevant to radiotherapy ,TSH,excessive iodine intake. Follicular thyroid cancer (10% to 20% of cases ) – occasionally seen in patients with Cowden syndrome.relevant to iodine deficiency. Medullary thyroid cancer (5%[10] to 8% of cases) – cancer of the parafollicular cells,relevant to gene. Anaplastic thyroid cancer (Less than 5%[10]) –It is not responsive to treatment and can cause pressure symptoms,could DIE quickly. THYROID CANCER Diagnosis＆Treatment DIGNOSIS: 1.Any throid mass having the following conditions should be considered malignant. ?General condition ：children(50%) ;male(increased rate); femal (over 60 or under 30). ? Symptom ＆Sign:painless ;small and hard and fixed solitary nodule;rapid growth(Ominous sign). ? Accessory examination：calcification;enlargement of neck lymph nodes. 2.Gold standard:pathological examination( fine-nee