Features of hyperthyroidism or hypothyroidism are not commonly seen in patients with thyroid malignancies as they rarely secrete thyroid hormones

• Positive family history - ?medullary

Investigations

• Flexible naso-laryngoscopy
• Ultrasound of the neck and core guided biopsy
  • Papillary cancer histology - orphan annie cells

Management of papillary and follicular cancer

• total thyroidectomy
• followed by radioiodine (I-131) to kill residual cells
• yearly thyroglobulin levels to detect early recurrent disease

Anaplastic thyroid cancer

Anaplastic thyroid cancer is an uncommon, extremely aggressive variant of thyroid cancer, accounting for 1-2% of cases, carries the highest mortality.

It occurs predominantly in woman, particularly in the 7th-8th decade of life.

Pathology: The disease is thought to be the result of de-differentiation of a well differentiated thyroid cancer (e.g. papillary or follicular variants).