Slabo diferencirani, inzularni, karcinom štitnjače

master's thesis

• Author: Rea Novak
• 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: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract

Slabo diferencirani (inzularni) karcinom štitnjače predstavlja heterogenu skupinu karcinoma, s varijabilnim ponašanjem, kliničkim tijekom i ishodom bolesti. Javlja se u 2 – 15% slučajeva svih karcinoma štitnjače, obično u starijoj životnoj dobi i češće u žena. Zbog svoje heterogene građe, za dijagnostiku karcinoma su 2006. godine predloženi Torinski kriteriji koji obuhvaćaju prisutnost solidne, trabekularne ili inzularne građe, odsutnost klasičnih nuklearnih obilježja papilarnog karcinoma, prisutnost jedne od agresivnijih obilježja karcinoma (atipične jezgre, povećana mitotička aktivnost tumorskih stanica te tumorska nekroza). Tumor se prezentira kao naglo rastući, bezbolan čvor na vratu, a mogu se javiti i nespecifični simptomi lokalne invazije u obliku dispneje, disfagije i promuklosti. Širi se limfogeno u regionalne limfne čvorove vrata, kao i hematogeno u pluća i kosti. U dijagnostici tumora koristi se ultrazvuk uz pridruženu citološku punkciju, histološka analiza tumorskog tkiva, dok se slikovne metode koriste za procjenu proširenosti bolesti i terapijskog pristupa. Kao terapijske opcije ističu se kirurško liječenje u vidu totalne tiroidektomije s pridruženom disekcijom vratnih limfnih čvorova, radiojodna terapija, terapija vanjskim snopom zračenja, ali i ciljana terapija upotrebom inhibitora tirozin kinaze. Tumor ima lošu prognozu, s petogodišnjim preživljenjem u 50% slučajeva i sklonosti recidivima.

Abstract (english)

Poorly differentiated thyroid cancer or insular cancer represents a heterogeneous group of cancers with variable behavior, clinical course and disease outcome. It occurs in 2 – 15% of all thyroid cancer cases, usually in older people and more often in females. Due to its heterogeneous structure, the Turin criteria were proposed in order to diagnose the cancer, which include the presence of either solid, trabecular or insular structure, the absence of nuclear features seen in papillary carcinoma and the presence of one or more aggressive features of cancer (atypical nuclei, increased mitotic activity of tumor cells, tumor necrosis). The tumor presents as a rapidly growing, painless neck nodule, and non-specific symptoms of local invasion, such as dyspnea, dysphagia and hoarseness may also occur. It spreads lymphogenously to the regional lymph nodes of the neck, as well as hematogenously to the lungs and bones. In the diagnosis of tumors, ultrasound with associated cytological aspiration is used along with hystological analysis of tumor tissue, while imaging methods are used to assess the extent of the disease and the therapeutic approach. Surgical treatment consisted of total thyroidectomy with associated cervical lymph node dissection is used as a first line of treatment, as well as radioiodine therapy, external beam therapy and targeted therapy using tyrosine kinase inhibitors. The tumor has a poor prognosis, with five-year survival in 50% of cases and a high tendency to relapse.

• Keywords: slabo diferencirani karcinom štitnjače; inzularni karcinom
• Keywords (english): poorly differentiated thyroid cancer; insular cancer
• Language: croatian
• URN:NBN: urn:nbn:hr:105:573625
• 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: 2024-07-02 15:32:57