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Reliable, easy-to-read patient information on common medical conditions β€” written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Medullary thyroid cancer differential diagnosis

Introduction

Overview

Overview

Medullary thyroid cancer must be differentiated from anaplastic thyroid carcinoma, papillary thyroid carcinoma, paraganglioma, carcinoid tumor, and Hurthle cell carcinoma.

Differentiating Medullary thyroid cancer from other Diseases

Differentiating Medullary thyroid cancer from other Diseases

  • Medullary thyroid cancer must be differentiated from the following:
Disease Name Age of Onset Gender Preponderance Signs/Symptoms Imaging Feature(s) Macroscopic Feature(s) Microscopic Feature(s) Laboratory Findings(s) Other Feature(s) Microscopic Appearance
Medullary Thyroid Cancer[1][2][3][4]
  • Incidence increases with age
  • More common in the 3rd to 4th decades of life
  • Both genders are affected equally
  • Single non-encapsulated mass
  • Gray-tan color
Source:Wikimedia common
Papillary Thyroid Cancer[5][6][4]
  • More common in the middle aged (30 – 50 years of age)
  • More commonly affects women
Source:Wikimedia commons
Follicular Thyroid Cancer[6][4][7]
  • More commonly affects women
Source:Wikimedia common
Anaplastic Thyroid Cancer[8][9][10]
  • More common among older individuals
  • Mean age at diagnosis is 65 years
  • More commonly affects women
    • Irregular margin
  • Imaging features are not characteristic of this cancer
Source:Wikimedia common
Follicular Adenoma[11]
  • More commonly affects individuals older than 50 years of age
  • More commonly affects women
  • Solitary nodule which may show echogenicity or not
  • Solitary, spherical, and encapsulated lesion
  • Well demarcated from the surrounding parenchyma
  • Functional adenoma:
    • Elevated T3, T4
    • Decreased TSH
  • May be considered functional or hot
  • May be considered non-functional or cold
Source:Wikimedia common
Multinodular Goiter[12]
  • Commonly affects individuals older than 60 years of age
  • More commonly affects women
Source:pathology outline, case courtesy of Dr. Swati Satturwar
Thyroid Lymphoma[13]

[14][15][16]

  • More common among women
Source:pathology outline, case courtesy of Dr. Mark R. Wick
Reference

Reference

  1. ↑ Busnardo B, Girelli ME, Simioni N, Nacamulli D, Busetto E (January 1984). “Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma”. Cancer. 53 (2): 278–85. doi:10.1002/1097-0142(19840115)53:2<278::aid-cncr2820530216>3.0.co;2-z. PMIDΒ 6690009.
  2. ↑ Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH (March 2000). “Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems”. Cancer. 88 (5): 1139–48. doi:10.1002/(sici)1097-0142(20000301)88:5<1139::aid-cncr26>3.0.co;2-z. PMIDΒ 10699905.
  3. ↑ Hofstra, Robert M. W.; Landsvater, Rudy M.; Ceccherini, Isabella; Stulp, Rein P.; Stelwagen, Tineke; Luo, Yin; Pasini, Barbara; Hoppener, Jo W. M.; van Amstel, Hans Kristian Ploos; Romeo, Giovanni; Lips, Cornells J. M.; Buys, Charles H. C. M. (1994). “A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma”. Nature. 367 (6461): 375–376. doi:10.1038/367375a0. ISSNΒ 0028-0836.
  4. ↑ 4.0 4.1 4.2 Sipos JA (December 2009). “Advances in ultrasound for the diagnosis and management of thyroid cancer”. Thyroid. 19 (12): 1363–72. doi:10.1089/thy.2009.1608. PMIDΒ 20001718.
  5. ↑ Fagin, James A.; Mitsiades, Nicholas (2008). “Molecular pathology of thyroid cancer: diagnostic and clinical implications”. Best Practice & Research Clinical Endocrinology & Metabolism. 22 (6): 955–969. doi:10.1016/j.beem.2008.09.017. ISSNΒ 1521-690X.
  6. ↑ 6.0 6.1 Schlumberger, Martin Jean (1998). “Papillary and Follicular Thyroid Carcinoma”. New England Journal of Medicine. 338 (5): 297–306. doi:10.1056/NEJM199801293380506. ISSNΒ 0028-4793.
  7. ↑ Pettersson B, Adami HO, Wilander E, Coleman MP (April 1991). “Trends in thyroid cancer incidence in Sweden, 1958-1981, by histopathologic type”. Int. J. Cancer. 48 (1): 28–33. doi:10.1002/ijc.2910480106. PMIDΒ 2019455.
  8. ↑ Nagaiah G, Hossain A, Mooney CJ, Parmentier J, Remick SC (2011). “Anaplastic thyroid cancer: a review of epidemiology, pathogenesis, and treatment”. J Oncol. 2011: 542358. doi:10.1155/2011/542358. PMCΒ 3136148. PMIDΒ 21772843.
  9. ↑ Chang TC, Liaw KY, Kuo SH, Chang CC, Chen FW (June 1989). “Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis”. Taiwan Yi Xue Hui Za Zhi. 88 (6): 551–6. PMIDΒ 2794956.
  10. ↑ Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA (July 1990). “Anaplastic carcinoma of the thyroid. A clinicopathologic study of 121 cases”. Cancer. 66 (2): 321–30. doi:10.1002/1097-0142(19900715)66:2<321::aid-cncr2820660221>3.0.co;2-a. PMIDΒ 1695118.
  11. ↑ Mathur, Aarti; Olson, Matthew T.; Zeiger, Martha A. (2014). “Follicular Lesions of the Thyroid”. Surgical Clinics of North America. 94 (3): 499–513. doi:10.1016/j.suc.2014.02.005. ISSNΒ 0039-6109.
  12. ↑ BronshteΔ­n ME, Makarov AD, Artemova AM, Bazarova EN, Kozlov GI (1994). “[Morphology of the thyroid tissue in multinodular euthyroid goiter]”. Probl Endokrinol (Mosk) (in Russian). 40 (2): 36–9. PMIDΒ 8197088.
  13. ↑ Pedersen RK, Pedersen NT (January 1996). “Primary non-Hodgkin’s lymphoma of the thyroid gland: a population based study”. Histopathology. 28 (1): 25–32. PMIDΒ 8838117.
  14. ↑ Hyjek E, Isaacson PG (November 1988). “Primary B cell lymphoma of the thyroid and its relationship to Hashimoto’s thyroiditis”. Hum. Pathol. 19 (11): 1315–26. doi:10.1016/s0046-8177(88)80287-9. PMIDΒ 3141260.
  15. ↑ Tupchong L, Hughes F, Harmer CL (October 1986). “Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment”. Int. J. Radiat. Oncol. Biol. Phys. 12 (10): 1813–21. doi:10.1016/0360-3016(86)90324-x. PMIDΒ 3759532.
  16. ↑ Ota H, Ito Y, Matsuzuka F, Kuma S, Fukata S, Morita S, Kobayashi K, Nakamura Y, Kakudo K, Amino N, Miyauchi A (October 2006). “Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid”. Thyroid. 16 (10): 983–7. doi:10.1089/thy.2006.16.983. PMIDΒ 17042683.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ammu Susheela, M.D. [3]