Oncosurgery

Prognosis Carcinoma thyroid

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Q) Not an important prognostic factor in Carcinoma thyroid (JIPMER)  ?
A. Age
B. Completeness of resection
C. Multicentricity
D. Extra thyroid extension

Ans c

In thyroid carcinoma, important prognostic factors include age (younger patients tend to have a better prognosis), completeness of resection (as complete removal of the tumor affects outcomes), and extra-thyroid extension (invasion beyond the thyroid worsens prognosis). However, multicentricity (the presence of multiple tumor foci within the thyroid) is generally not considered a major prognostic factor.

Most of the papillary carcinoma are multicentric any way

 

As per AGES And AMES criteria.

HIgh risk - Male. Age more than 40 years, Size more than 4 cm, Capsular or extra thyroid extension, Regional or distant metastasis and poor differentiation

Low Risk - Well differentiated less than 2 cm. Age benefit is extended to 50 yrs in women

 

IN younger patients (<45 years old), the presence of lymph node metastases had no effect on the excellent overall survival, but the presence of lymph node metastases increased the risk of death by 46% in patients older than 45

The presence of lymph node metastasis in patients with contained intrathyroidal primary papillary carcinoma also does not affect
long-term survival.

If there is gross or microscopic extension of a primary PTC through the thyroid capsule, a poor prognosis and
possibly a higher rate of lymph node metastasis may be anticipated.

Malignant features of salivary gland tumors

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Q) 54 year old lady with long standing swelling right side of cheek. What is not a clinical feature of malignant conversion of salivary gland tumor?

a) Pain 

b) Facial nerve weakness

c) Swelling

d) Cervical lymph node swelling

Ans a

Clinical features of high-grade malignant salivary tumours include

1. facial nerve weakness

2. rapid enlargement of the swelling; 

3. induration and/or ulceration of the overlying skin;

4. cervical node enlargement.

Ref Bailey 27th page 783

Most of these tumors are painless

More Questions Head and Neck onco 

Superior Vena cava Syndrome

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Q) What is the definitive management option for the superior vena cava syndrome?

A)Bed rest and oxygen administration

B)Diuretic therapy

C)Prophylactic anticoagulant

D)Removal of the underlying  malignancy

Medullary carcinoma thyroid

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Premium MCQ - Thyroid
Q) Medullary carcinoma thyroid, what test is not done (NEET 2019)
a) Calcitonin
b) Glucagon
c) VMA
d) CEA
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Lymph nodes in neck

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Q) Most common site for lymph node spread is ? (head and neck Onco) 

a) Tongue

b) Lip

c) NAsopharynx

d) Glottis

Ans c

 Primary sites within the pharynx (i.e., nasopharynx, oropharynx, and hypopharynx) and supraglottic larynx  are particularly high risk.

The oral cavity has an intermediate risk,

whereas the glottic larynx, nasal cavity, and paranasal sinuses are low risk. Other predictors of risk of metastases are higher T stage and thickness (in case of oral cavity cancers).