Thyroid Tumor

Thyroid tumors are divided into benign and malignant. Benign include thyroid adenoma and cysts. Over 95% of malignant tumors are primary thyroid carcinoma; rare are malignant lymphoma and metastatic tumors. Histologically thyroid carcinoma is divided into papillary, follicular, anaplastic and medullary. Papillary is most common, accounting for 60%-80%. Thyroid carcinoma can occur at any age, peaking at 49-69 years; more women than men. Papillary thyroid carcinoma has low malignancy, grows slowly, spreads mainly via lymphatics; after surgery survival is long and prognosis good. Anaplastic thyroid carcinoma mostly affects older patients, high malignancy, early lymph/hematogenous spread; symptoms are obvious so patients usually seek care promptly, but distant metastasis has often already occurred. Medullary thyroid carcinoma arises from C cells; seen at any age; smaller tumors almost always in the upper posterior part of one lobe; has specific clinical features; 5%-10% have family history; elevated serum calcitonin helps diagnosis.

Common Symptoms

Progressive neck mass; hoarseness; jugular-vein distension; dyspnea; dysphagia; cervical lymphadenopathy

Causes and Pathogenesis

Causes of thyroid nodules are complex, closely related to heredity and certain environmental factors. Abnormal iodine intake, infection, immune dysfunction, stress and radiation exposure also play important roles in nodule development. Benign thyroid tumor: TCM holds this disease is closely related to emotional disturbance, unfavorable living conditions and healthy-qi deficiency allowing pathogen invasion. 1. Emotional disturbance: grief, anxiety, depression, anger cause liver-qi stagnation and loss of smooth flow; liver wood overacts on earth → spleen loses transportation → phlegm-dampness retains; or liver-stagnation transforms to fire, condensing body fluids into phlegm. Turbid qi and phlegm-dampness coagulate in the neck; liver-qi stagnation and blood-stasis block collaterals, accumulating upward into goiter. 2. Unfavorable living: long residence in mountainous/highland areas with poor water quality; over time qi-flow disorders, water-dampness retains, phlegm and stasis bind → goiter. 3. Healthy-qi deficiency with pathogen invasion: weak healthy-qi allows pathogen to invade, blocking collaterals and coagulating blood-stasis in front of the neck; congenital deficiency with weak constitution and pathogen/fire binding in the neck. In short, the disease is closely related to liver and spleen; under multiple factors qi, blood and phlegm coagulate, producing qi stagnation, blood stasis and phlegm binding in the neck, forming a tangible mass over time. Pure TCM treatment is best — treats both root and branch, stable/ideal efficacy, no side effects, no recurrence after cure. TCM syndrome-differentiated treatment controls disease, relieves symptoms and promotes recovery; patients should maintain health care. Malignant thyroid tumor: Mechanism unclear, but related factors include: 1. Oncogenes and growth factors: modern research shows many animal/human tumors relate to overexpression, mutation or deletion of proto-oncogene sequences. 2. Ionizing radiation: head/neck external radiotherapy is a major thyroid carcinogen. 3. Heredity: some medullary carcinomas are autosomal-dominant; family history is often elicited in thyroid-cancer patients. 4. Iodine deficiency: proposed as early as the 20th century. 5. Estrogen: recent studies suggest estrogen affects thyroid growth mainly by stimulating pituitary TSH release (plasma TSH rises with estrogen); direct thyroid effect is unclear.

Treatment

Drug therapy, supportive therapy, surgery

Preventive Measures

1. Guide patient to regular lifestyle, good rest and adequate sleep, reasonable diet/schedule, and balanced mental attitude. 2. Strengthen outdoor activity — walking, jogging, qigong, tai chi, aerobics — to promote circulation/metabolism/immunity and prevent colds/respiratory infections; choose non-competitive activities. 3. Thyroid cancer is a heterogeneous group with widely varying prognosis. Differentiated carcinomas (e.g. papillary) after excision need active combined treatment; post-op long-term thyroxine per medical order; distant metastasis needs 131I. Explain to patient/family that with compliant treatment, good mental attitude, reasonable diet and self-care, most patients survive long. 4. For highly malignant anaplastic/poorly differentiated cancer, guide regular radiotherapy/chemotherapy per medical order to prolong life and improve quality of life. Late-stage thyroid-cancer nursing. 5. Regular follow-up: differentiated carcinoma — regular thyroglobulin and 131I scans; medullary carcinoma — regular calcitonin and CEA; anaplastic or non-iodine-avid differentiated cancer — regular B-ultrasound, CT, MRI, thallium scan or whole-body PET-CT to detect recurrence/metastasis early. 6. Self-observe subtle changes, especially neck mass/nodules/pain/hoarseness/dysphagia and abnormal sensations elsewhere; seek care promptly.

Department to Visit

It is recommended to visit the General Surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.