Adrenal, Thyroid, Parathyroid Glands Flashcards Preview

Surgery Objectives > Adrenal, Thyroid, Parathyroid Glands > Flashcards

Flashcards in Adrenal, Thyroid, Parathyroid Glands Deck (16)
1

reasons to operate on adrenal glands?

  • primary hyperaldosteronism
  • pheochromocytoma
  • hypercortisolism (Cushing disease or Cushing syndrome)
  • adrenocortical carcinoma​

2

wtf is an adrenal incidentaloma?

 

tumor found in the adrenal gland incidentally on CT

tx? almost all surgeons agree solid incidentalomas >6cm should be removed (greater risk of developing into carcinoma)

 

 

3

What's the most common cause of thyroid enlargement?

multinodular goiter

about 1% of these are malignant

4

What is a hot vs. cold thyroid nodule?

Hot - increased uptake of I-123=>functioning/hyperfunctioning nodule

Cold - decreased uptake of I-123

Hot nodules are virtually never malignant

Cold nodules have a chance of being/becoming malignant

HOT = GOOD (compared to cold)

5

What are the types of thyroid cancer?

Papillary

Follicular

Medullary

Anaplastic

6

What are the surgical options for thyroid cancer?

Total thyroidectomy

Unilateral lobectomy with isthusmectomy

with or without cervical node resection

7

What are the indications for total thyroidectomy versus lobectomy?

Total thyroidectomy is better if:

  • primary tumor > 1cm
  • extrathyroidal extensions or metastases
  • > 5 foci
  • medullary cancer

8

What is the general prognosis for papillary thyroid cancer?

Most patients with papillary thyroid cancer do not die of their disease

9

What is the general prognosis for follicular thyroid cancer?

Compared to papillary thyroid cancer, follicular thyroid cancer is more aggressive, more likely to have metastases, and has a higher mortality

10

What is the general prognosis for medullary thyroid cancer?

If patient is < 40yo at time of diagnosis, 10 year survival rate is 65%

If patient is > 40yo at time of diagnosis 10 year survival is 50%

11

What is the general prognosis for anaplastic thyroid cancer?

Bad

--very rapid course of disease progression

--poor treatment outcomes

--end of life issues and plans for comfort care measures are an integral part of initial disease management planning

12

What are some complications of thyroid cancer surgery?

Hypoparathyroidism

Damage to nerves - recurrent laryngeal, superior laryngeal

Bleeding

Thyrotoxic storm

13

Hey, did you know that medullary thyroid cancer can be inherited?

14

What are the indications for parathyroid surgery?

Surgery is the mainstay of treatment for parathyroid cancer.

Dx based on biopsy.

Why get biopsy/suspect cancer: hypercalcemia, neck mass, renal disease, bone disease

15

What are the postoperative complications of parathyroidectomy?

1. Hungry bone syndrome

2. Nerve damage e.g. recurrent laryngeal nerve

16

What is hungry bone syndrome?

A serious complication that may occur after parathyroidectomy.

Rapid, profound, and prolonged hypocalcaemia, exacerbated by suppressed parathyroid hormone (PTH) levels