Thyroid cancer is the most common malignant tumor of the thyroid gland and the vast majority of them originate from follicular epithelial cells. The disease progresses slowly, mostly for months to years or even longer, and is detected by patients with neck discomfort or without any symptoms. Clinical manifestations In the early stage, hard nodules are found in the gland, which move up and down with swallowing; when the tumor increases to a certain extent, it can compress the trachea and displace the trachea, and there are different degrees of breathing disorders. When the tumor invades the trachea, it can produce dyspnea; when it compresses the esophagus, it can cause dysphagia; when it invades the recurrent laryngeal nerve, it can cause hoarseness; when the tumor has lymph node metastasis, the most common one is the swollen lymph nodes that can be palpated in the middle and lower neck. Zhang Shuguang, Head and Neck Surgery Department, Shandong Institute of Cancer Control and Prevention Ancillary examinations Blood check, ultrasound of neck, X-ray plain film, CT, MRI, nuclear examination, ultrasound-guided fine needle aspiration cytology, molecular testing, final diagnosis is confirmed by pathological examination. Pathological types 1.Papillary carcinoma: It is a low-grade malignant tumor and is the most common pathological type of thyroid cancer, accounting for about 60% to 70% of thyroid cancer, with good prognosis. Follicular carcinoma: About 20% of thyroid cancer has slow development, rapid hematogenous dissemination and distant metastasis to lung or bone. Because of its histocytological resemblance to thyroid follicular structure and iodine-absorbing function, a few patients may show hyperthyroidism and increase the rate of 131I absorption, and advanced tumors may also cause superior vena cava compression syndrome. Medullary thyroid carcinoma: This disease is more malignant and invades the lymphatic ducts of thyroid gland in early stage, and soon metastasizes to extra-glandular and cervical lymph nodes, and can also metastasize distantly through blood vessels. Sometimes enlarged lymph nodes may be the first symptom. The presence of heterogenous ACTH can produce a significant increase in serum calcitonin levels, which is the most characteristic feature of the disease, making calcitonin a diagnostic marker. Undifferentiated thyroid cancer: It is a highly malignant tumor, accounting for 2% to 3% of thyroid cancer, and the age of onset is more than 65 years old. Due to its high malignancy and rapid development, it easily invades surrounding tissues and organs, and even forms masses in the interstitial space between trachea and esophagus, causing breathing and swallowing disorders. The prognosis of undifferentiated carcinoma is very poor, with an average survival time of 3-6 months. 5.Rare pathological types of thyroid cancer (1) thyroid lymphoma (2) metastatic thyroid cancer (3) squamous thyroid cancer Treatment options 1.Surgical treatment: thyroid lobectomy; total thyroidectomy; central region clearance; lymph node clearance of one side of the neck; palliative thyroidectomy (tumor with external invasion), etc. 2.Endocrine therapy: thyroxine can inhibit the secretion of thyrotropin, thus inhibiting the proliferation of thyroid tissues and well differentiated carcinomas. 3.Radiation therapy: Iodine 131 internal radiation therapy mainly treats metastatic lesions that can concentrate iodine, and can also be used to treat primary cancer that cannot be operated and/or cannot be completely removed by surgery. Undifferentiated cancer is mainly treated by external radiation therapy. 4.Molecular targeted drug therapy: Sorafenib (Doxorubicin) and other drug therapy.