Papillary adenocarcinoma of the thyroid

• most commonly recognised thyroid cancer and the most easily diagnosed by fine needle biopsy
• accounts for about 80% of thyroid carcinoma
• women are affected more often than men
• papillary carcinomas occur rather evenly from the third to seventh decade and account for 80% of all thyroid cancer in individuals under 40 years of age
• usually presents as a solitary nodule in a patient with normal thyroid hormone levels; cancer is found in about 10% of such cases
  • other symptoms are uncommon, but include cervical lymphadenopathy, hoarseness, difficulty in breathing or swallowing, and discomfort in the neck

Histologically, it shows papillae around a fibrovascular stalk and usually contains elements of follicular differentiation. It is slow growing and may be asymptomatic for many years. It is often multifocal. Local spread to regional nodes in the neck and mediastinum is common and 50% of patients show nodal metastases at the time of death.

It is not uncommon for a local lymph node metastasis to be detected before the primary tumour. Early metastases of this type have been termed "lateral aberrant thyroid".

Distant metastasis to the lungs or bone is rare.

Usually treated with surgery, which can be supplemented with radioiodine ablation. Survival rates are excellent

Reference:

1. NICE (November 2004). Improving outcomes in head and neck cancers - The Manual