symptoms, causes, tests and treatments

Pay attention to the symptoms

First of all, this tumor form in many cases does not show clear signs in the early stages of the disease. “It generally grows slowly and quietly. – explains the expert. The alarm bell it can be represented by an isolated nodule in the gland found on palpation “.

Be careful though. It should be remembered that in most cases the nodule is only the expression of a thyroid hyperplasia, that is a benign manifestation that causes an increase in the volume of the gland. “In the most advanced phase, however, different signs and symptoms may arise – continues Fugazzola. For example, attention must be paid to the voice, which can manifest lowering or alterations in tone, as well as the rapid growth of a swelling in the neck or the appearance of masses in the lateral parts of the neck itself “.

To define the risk, it should be remembered that familiarity represents an element to consider, in addition to exposure to radiation. “The genetic alterations responsible for almost all thyroid tumors are known – says the expert. It is about genetic alterations which can be found in the tumor or, in the case of familial forms, in the blood. In this case, the detection of the mutated gene in the relatives of an affected person indicates the presence of an early stage tumor or indicates its future development, thus allowing the removal of the thyroid to be carried out early and thus leading to complete recovery “.

How to get to the diagnosis

Obviously, not all cancers are the same. And it is necessary to understand well what it is, also to implement targeted treatments on a case-by-case basis. “The most common is papillary carcinoma which arises especially between the ages of 30 and 50 – Fugazzola says. It consists of a well-confined and localized swelling which, especially if it occurs in young subjects, in 99% of cases does not cause complications for life. There follicular form instead it occurs in older people and is more aggressive. Finally the medullary carcinoma it is extremely rare and does not involve the actual thyroid cells but rather the C or parafollicular cells, responsible for the production of another hormone: calcitonin). In 25% of cases this tumor is part of a family syndrome, genetically inherited and called MEN 2. Finally, anaplastic carcinoma arises after the age of 60, and is very aggressive because the cells multiply very quickly. Thyroid lymphoma, on the other hand, is a rare and very aggressive form “.

To arrive at the diagnosis, in addition to revealing any other cases in the family, the specialist assesses the growth rate of the nodule, its characteristics and the possible presence of swollen lymphatic glands in the lateral part of the neck. With blood tests gland function (TSH) is evaluated and calcitonin, a marker of medullary thyroid cancer.

“Ultrasound is fundamental, since most malignant thyroid nodules have“ suspicious ”ultrasound features, concludes Fugazzola. The definitive confirmation of the tumor is obtained by carrying out a cytological examination using fine needle aspiration that examines the characteristics of the cells that make up the nodule. In 10-25% of cases, however, cytology is not decisive, it is not able to distinguish between benign and malignant nodules.

In these cases it is possible to carry out a genetic analysis starting from the fine needle aspiration that allows to identify the genetic mutations that cause thyroid tumors or their absence, thus helping in the differentiation between benign and malignant nodules. Finally, as a final diagnostic study, and only in the case in which it is necessary to establish the precise location of the tumor before surgery, a CT or magnetic resonance imaging can be performed to better observe the malignant nodule, the relationships with the structures surrounding and any metastases “.