Treatment of thyroid tumor
treatment of thyroid tumor
according to the type of thyroid tumor, The treatment methods mainly include drug treatment (conservative treatment) and surgical treatment.
1,
thyroid adenomas are generally treated by surgery, but drug treatment can make a small number of patients’ tumors shrink or even disappear. In order to avoid unnecessary surgery, when the focus is less than 2cm, drug treatment can be considered first, and surgical resection can be performed when it is ineffective.
2. Nodular goiter
because nodular goiter shows bilobar multiple nodule growth, the effect of simple surgical removal is not good, it is very easy to relapse, and there are many complications after total thyroidectomy, so conservative treatment is mainly used in principle. Less than 5% of patients with nodular goiter need surgical treatment, and most people can even live with tumor for life. Surgical resection should be performed unless there are obvious compression symptoms, hyperthyroidism, mass extending to mediastinum or suspected malignant transformation.
3,
thyroid cancer generally requires surgical treatment. The traditional surgical treatment is to make an incision under the neck, remove the thyroid and do lymph node dissection. The operation requires the removal of all thyroid tissue on the side of the tumor, which is the lowest range of thyroidectomy. If there are nodules or malignant tumors in the contralateral thyroid, the contralateral tumor resection, subtotal resection, or even total resection of the contralateral thyroid should be done according to different conditions. If there is metastasis, expand the scope of lymph node dissection according to the location of cancer cells. In recent years, there are great disputes about minimally invasive surgery, radiofrequency therapy and ablation therapy. These treatment methods can not be carried out according to the required resection range, and may not reach the required range of tumor treatment.
iodine therapy is a very important treatment for thyroid papillary carcinoma and follicular carcinoma, and it is also an important supplement to thyroid surgery. Thyroid tissues, including thyroid tumors, will absorb iodine, and iodine will release a kind of radiation in the human body to kill the tumor. This is the principle of iodine therapy. Therefore, iodine therapy is called & ldquo; Internal radiotherapy & rdquo;. However, the premise of iodine treatment is to remove all thyroid tissues and clean up all lymph nodes with serious metastasis as far as possible. Some people go for iodine treatment without cutting off all their thyroid. At this time, even if the dose of iodine is large, it will be absorbed by the thyroid. The metastatic lesions can not be absorbed at all, so there is no therapeutic effect. Patients with serious conditions (such as patients with high risk of recurrence) can be treated with iodine.
thyroid tumor examination
1. Physical examination: note that the tumor is located in one leaf or the whole thyroid, and accurately record its shape, mobility, hardness and the degree of up and down movement during swallowing. Investigate the relationship between the tumor and adjacent tissues and organs (such as clavicle, carotid artery, esophagus, trachea, larynx, etc.). The number, location, nature and mobility of cervical lymph nodes were recorded in detail.
2. In the medical history, pay attention to the discovery time, initial location and growth rate of the tumor, whether there are symptoms such as compression of trachea and esophagus, cough and hoarseness, whether there are manifestations of hyperthyroidism, whether there are radiotherapy officials of head and neck and family history.
3. When it is difficult to diagnose, the following examinations can be performed: B-ultrasound, thyroid radionuclide scanning; Serum antithyroid globulin antibody, antithyroid microsomal antibody, immunoglobulin, T3, T4, thyroglobulin (TG), TSH, etc.
4. If necessary, make X-ray examination of neck and chest, observe the position, displacement direction and degree of larynx and trachea, and determine whether the tumor extends behind sternum and metastases to lung.
5. Please consult the otolaryngology department to check the position and function of vocal cords.
6. If necessary, check ESR, blood calcium, urinary calcium, calcitonin, etc.
7. Pay attention to the differentiation of malignant tumor from chronic thyroiditis and nodular goiter, and make fine needle aspiration cytology or surgical biopsy if necessary.