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

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