Dijagnostika i liječenje diferenciranih karcinoma štitnjače

master's thesis

• Title (english): Diagnosis and treatment of differentiated thyroid carcinoma
• Author: Valentina Pavlić
• Mentor: Sanja Kusačić Kuna (mentor)
• Committee member: Dražen Huić (predsjednik povjerenstva)
• Committee member: Lovorka Batelja-Vuletić (član povjerenstva)
• Committee member: Sanja Kusačić Kuna (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Nuclear Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Nuclear Medicine

Abstract

Diferencirani karcinomi štitnjače su najčešći maligni tumori štitnjače koji nastaju iz folikularnog epitela štitinjače, a to su papilarni i folikularni tip. Papilarni karcinom je češći i nalazimo ga u 65-80% bolesnika. Najčešće se razvija u žena mlađe i srednje životne dobi, većinom je niskog stupnja malignosti i vrlo dobre prognoze. Na folikularni karcinom otpada oko 10-20% svih oblika malignih tumora štitnjače. Folikularni karcinomi su maligniji od papilarnih i šire se hematogeno, najčešće u pluća i kosti. U dijagnostici primarno koristimo ultrazvuk i ciljanu citološku punkciju, a preoperativno je ultrazvukom potrebno pregledati i cijeli vrat u cilju detekcije eventualno prisutnih metastaza u limfne čvorove kako bi se odredio opseg operacijskog zahvata. Liječenje se provodi totalnom tireoidektomijom nakon čega slijedi primjena radioaktivnog joda 131 u cilju uništenja ostatnog tkiva štitnjače tj. radiojodna ablacija, a potom se do potvrde remisije bolesti uvodi supresijska terapija levotiroksinom. Prognoza bolesnika je uglavnom dobra, a kontrole bolesnika se provode redovitim ultrazvučnim pregledima vrata uz određivanje tireoglobulina iz krvi bolesnika te po potrebi scintigrafijom cijelog tijela s malim dijagnostičkim dozama radiojoda. Od ostalih dijagnostičkih pretraga kod sumnje na proširenu bolest koriste se MSCT, PET-CT i MR.

Abstract (english)

Differentiated thyroid cancers are the most common malignant thyroid tumors arising from the follicular epithelium of the thyroid gland and include papillary and follicular types. Papillary carcinoma is more common and is found in 65-80% of patients. It most often develops in young and middle-aged women, is generally of low degree of malignancy and has a very good prognosis. Follicular carcinoma accounts for 10-20% of all forms of malignant thyroid tumors, they are more malignant than papillary and spread hematogenously, most often to the lungs and bones. In preoperative diagnosis, the procedure of choice is ultrasound of thyroid as well as whole neck echography with targeted fine needle aspiration biopsy in order to determine possible metastases in the neck. The initial treatment mainly involves total thyroidectomy followed by radioiodine
ablation and then levothyroxine suppression therapy is introduced until the remission of the disease is confirmed. The prognosis is generally good, and monitoring of patients is carried out by regular ultrasound examinations of the neck with the determination of thyroglobulin from the patient's blood and, if necessary, whole body scintigraphy with diagnostic activities of iodine-131 is performed. If extended disease is suspected, additional tests such as MSCT, PET/CT and MRI could be performed.

• Keywords: papilarni karcinom; folikularni karcinom; tireoidektomija; radiojodna ablacija
• Keywords (english): papillary carcinoma; follicular carcinoma; thyroidectomy; radioiodine ablation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:019799
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-26 11:56:08