Thyroid anatomy and surgery and management.pptx

Surgery

1. Thyroid Diseases - Neoplastic Dr Manjiri

2. Thyroid Neoplasms Benign Follicular Adenoma Malignant Follicular carcinoma Papillary carcinoma Medullary carcinoma Anaplastic carcinoma

3. Solitary nodule of the Thyroid : Solitary nodules ….. Neoplastic Nodules in younger patients ….. Neoplastic Nodules in males ……neoplastic. H istory of radiation treatment to the head and neck region ….neoplastic * Nodules that take up radioactive iodine in imaging studies (Hot nodules) …..more likely to be benign than malignant.

4. Thyroid carcinomas : Papillary carcinoma (75% to 85% of cases) Follicular carcinoma (10% to 20% of cases) Medullary carcinoma (5% of cases) * Anaplastic carcinoma (<5% of cases)

5. Papillary Carcinoma - Thyroid Cell of origin Epidemiology Etiopathogenesis Common sites Gross Microscopy -types Spread Clinical features Diagnosis Prognosis Treatment

6. Papillary Carcinoma - Thyroid 1 . Cell of origin – Thyroid follicular cell 2 . Epidemiology – Middle age, Females 3 . Etiopathogenesis – Genetic, Environmental 4 . Common sites – one lobe 5 . Gross – Solitary nodule / cyst with papillae 6 . Microscopy – types details diagram

7. Papillary carcinoma of the thyroid- --papillary structures .

8. Papillary carcinoma of the thyroid --- well-formed papillae

9. cells with characteristic empty-appearing nuclei, sometimes termed "Orphan Annie eye" nuclei.

10. Various Types Conventional Follicular variant Tall cell variant Micro-carcinoma Oncocytic Columnar cell Encapsulated Diffuse sclerosing

11. Papillary Carcinoma - Thyroid Spread – Lymphatic route to cervical LN Clinical features – Solitary nodule, L.N. Diagnosis – FNAC, Histopathology Prognosis – Good , Depends on the stage Treatment – Surgery, Radiothearapy

12. Papillary Microcarcinoma

13. Follicular Carcinoma

14. Follicular Carcinoma Solitary nodule Show Follicles Invasion of capsule Vascular spread Etiopathogenesis

15. Medullary Carcinoma From C cells Neuroendocrine Part of MEN syndrome Shows amyloid Paraneoplastic syndromes

16. Anaplastic Carcinoma Undifferentiated High grade Poor prognosis

17. Follicular Carcinoma - Thyroid Cell of origin Epidemiology Etiopathogenesis Common sites Gross Microscopy - types Spread Clinical features Diagnosis Prognosis Treatment

18. Benign Tumour

19. Follicular Adenoma

20. Tumours of thyroid ??

21. Causes for solitary nodules in thyroid ?

22. Best Wishes !

23. Parathyroid Diseases

24. Hyperparathyoidism Hypoparathyroidism

25. Primary hyperparathyroidism Adenoma : 75% to 80% Primary hyperplasia (diffuse or nodular): 10% to 15% Parathyroid carcinoma: less than 5%

26. Secondary hyperparathyroidism low serum calcium - compensatory overactivity of the parathyroid glands. Renal failure - most common, inadequate dietary intake of calcium vitamin D deficiency.

27. Hyperparathyroidism – Clinical Features

28. Parathyroid adenoma.

29. Hypoparathyroidism Surgically induced Congenital absence of all glands Familial hypoparathyroidism Idiopathic hypoparathyroidism most likely represents an autoimmune disease