Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, accounting for about 85% of all cases. It occurs in young adults aged 20 to 40 years, and is more common in women. Under the microscope of pathologists, it can be divided into many subtypes. PTC is a differentiated type of cancer, which means that most patients have low malignancy, slow growth, and can live a long life with treatment.
A special reminder is that the PTC family has a “little” friend: microscopic cancer. It is no more than 1 cm in diameter and has no obvious symptoms, so many people find it by accident during a physical exam. Some microscopic cancers are not dangerous and do not require surgery to remove, but just need to be reviewed regularly as directed by your doctor.
Symptoms
PTC is less likely to metastasize systemically, so it is common to have symptoms localized to the lesion. When the mass compresses the trachea, shortness of breath, dyspnea, hemoptysis, and a feeling of suffocation in the chest may occur. When the mass compresses the esophagus, less severe cases may experience discomfort in eating and choking, and more severe cases may even be unable to eat. In the long term, patients can suffer from malnutrition and weight loss.
B ultrasound at this time often reveals nodules or masses in the thyroid gland, sometimes invading the thyroid envelope and metastasizing to the cervical lymph nodes.
Staging and treatment principles
Papillary carcinoma staging is age-related, with an age cutoff of 55 years, with only stages I and II under age 55 and stages I-IV over age 55. If you want to know exactly how it is staged, please click below:
The standardized treatment of differentiated thyroid cancer is mainly surgery, and the subsequent treatment plan is decided after surgery according to the tumor stage and the high risk of recurrence, which consists of the following three parts:
- Surgical resection of the primary site and potentially resectable metastatic lesions.
- A subset of patients require radioactive iodine (RAI) therapy to destroy residual thyroid tissue after surgery and occult or inoperable metastatic lesions.
- Most patients need to take thyroid hormone pills for life to replenish thyroxine and inhibit tumor recurrence and growth.
If you would like more information about the above treatments, please click below:
Co-written by Dr. Kai Qian, Fudan University Cancer Hospital Dr. Kai Guo