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thyroid carcinomas

Monday 24 June 2013

thyroid cancer

See also : thyroid tumors

WHO Classification (2004)

- Thyroid carcinomas

  • papillary thyroid carcinoma (PTC)
  • follicular thyroid carcinoma (FTC)
  • thyroid poorly differentiated carcinoma
  • thyroid undifferentiated carcinoma (thyroid anaplastic carcinoma)
  • anaplastic squamous cell carcinoma
  • Mucoepidermoid carcinoma
  • anaplastic sclerosing mucoepidermoid carcinoma with eosinophilia
  • anaplastic mucinous carcinoma
  • medullary thyroid carcinoma
  • mixed medullary and follicular cell carcinoma
  • spindle cell tumor with thymus-like differentiation (SETTLE)
  • carcinoma showing thymus-like differentiation (CASTLE)

TNM staging system 2007

Primary tumor (T)

- TX Primary tumor cannot be assessed
- T0 No evidence of primary tumor
- T1 Tumor 2 cm or less in its greatest dimension, limited to the thyroid
- T2 Tumor more than 2 cm, but not more than 4 cm in its greatest dimension, limited to the thyroid
- T3 Tumor more than 4 cm in its greatest dimension limited to the thyroid or any
tumor with minimal extrathyroidal extension (e.g., extension to sternothyroid
muscle or perithyroid soft tissues)
- T4a Tumor of any size extending beyond the thyroid capsule to invade
subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve
- T4b Tumor invades prevertebral fascia or encases carotid artery or mediastinal vessels

Regional lymph nodes (N)
- NX Regional lymph nodes cannot be assessed
- N0 No regional lymph node metastasis
- N1 Regional lymph node metastasis

  • N1a Metastasis to level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes)
  • N1b Metastasis to unilateral, bilateral, or contralateral cervical or superior mediastinal lymph nodes

Distant metastasis (M)
- MX Distant metastasis cannot be assessed
- M0 No distant metastasis
- M1 Distant metastasis


See also

- thyroid adenomas and related tumors:

- Other thyroid tumors:

  • thyroid teratoma
  • primary thyroid lymphomas and thyroid plasmacytoma
  • ectopic thymoma
  • thyroid angiosarcoma
  • thyroid smooth muscle tumors
  • thyroid peripheral nerve sheath tumors
  • thyroid paraganglioma
  • thyroid solitary fibrous tumor
  • thyroid follicular dendritic cell tumor
  • thyroid Langerhans cell histiocytosis
  • thyroid secondary tumors


- Management of Invasive Thyroid Carcinoma. Camysha Wright, MD, Vicente Resto, MD, PhD. 2007;

Molecular biology

- BRAF-V600E is specific for papillary carcinoma. It is found in anaplastic thyroid carcinoma when it arises from papillary thyroid carcinoma.

- Ras mutations are found in 50% of anaplastic thyroid carcinomas compared to 70% harboring p53 mutations.

- Ret rearrangements are found in medullary carcinoma.

- Pax-8 PPAR-gamma is found in follicular lesions: follicular carcinoma, some follicular adenomas and follicular variants of papillary carcinoma.

- p53 is most commonly mutated in anaplastic thyroid carcinoma (70%), followed by beta-catenin (60%) and ras (50%) . If the carcinoma has BRAF V600E, than it is arising from papillary thyroid carcinoma.

- Mutations in anaplastic thyroid carcinoma: p53 (70%), beta-catenin (60%) and ras (50%). If the carcinoma has BRAF V600E, then it is arising from papillary thyroid carcinoma.