thyroid甲状腺癌全英文简版ppt课件

1、.,1,Thyroid Cancer,Shuguang Hospital General Surgery VINCENT Rao,.,2,THYROID CANCER,1 where is it？ ANATOMY,2 why did it happen？ ETIOLOGY,.,3,1.Apperance: the largest endocrine glands:butterfly-shaped of two side lobes connected by isthmus .2.Location:below the thyroid cartilage,around larynx and tra

2、chea。 5 cm long, 3 cm wide and 2 cm thick。top to the middle of thyroid cartilage ,down to the fifth or sixth tracheal ring。,THYROID ANATOMY,.,4,From skin to thyroid：skin superficial fascia（platysma） superficial layer of deep fascia infrahyoid musclesPretracheal fasciathyroid,THYROID ANATOMY,.,5,3.Ne

3、rves and vessels (both coupled):2 nerves :superior laryngeal nerve + recurrent laryngeal nerve.2 arterys:superior and inferior thyroid arterys3 veins:superior 、middle and inferior thyroid veins.4.Lymphatic drainage: knowing the way how throid cancer cell transfers is the foundation to lymphadenectom

4、y .,THYROID ANATOMY,.,6,Diagram of cervical lymph node levels,Level IA : bounded by anterior belly and hyoid bone. Level IB : bounded by the anterior and posterior bellies and the mandible. Level VI (Central compartment lymph nodes):bounded by hyoid bone , the common carotid arteries and the sternum

5、 .Although level VI is large in area, the few lymph nodes that it contains are mostly in the paratracheal regions near the thyroid gland. Level VII:superior mediastinum lymph nodes.,.,7,Diagram of cervical lymph node levels,Level V： posterior triangle of neck Level II: bounded by skull base, stylohy

6、oid muscle, hyoid bone horizontal line and posterior edge of the sternocleidomastoid muscle. Level III :begins at the inferior edge of level II and is bounded by the laryngeal strap muscles anteriorly, by the posterior border of the sternocleidomastoid muscle posteriorly, and by a horizontal plane e

7、xtending posteriorly from the inferior border of the cricoid cartilage. Level IV :begins at the inferior border of level III and is bounded anteriorly by the strap muscles, posteriorly by the posterior edge of the sternocleidomastoid muscle, and inferiorly by the clavicle.,.,8,lymph node metastases

8、of Thyroid cancer,Study shows that : VI is often the first level The second is level III、IV Level VII、II、V、I is not frequent .,.,9,THYROID CANCER,1 where is it？ ANATOMY,2 why did it happen？ ETIOLOGY,.,10,ETIOLOGY,Based on classification : Papillary thyroid cancer (75% to 85% of cases ) often in youn

9、g females excellent prognosis. relevant to radiotherapy ,TSH,excessive iodine intake. Follicular thyroid cancer (10% to 20% of cases ) occasionally seen in patients with Cowden syndrome.relevant to iodine deficiency. Medullary thyroid cancer (5%10 to 8% of cases) cancer of the parafollicular cells,r

10、elevant to gene. Anaplastic thyroid cancer (Less than 5%10) It is not responsive to treatment and can cause pressure symptoms,could DIE quickly.,.,11,THYROID CANCER,1 where is it？ ANATOMY,2 why did it happen？ ETIOLOGY,.,12,DiagnosisTreatment,DIGNOSIS: 1.Any throid mass having the following condition

11、s should be considered malignant. General condition ：children(50%) ;male(increased rate); femal (over 60 or under 30). Symptom Sign:painless ;small and hard and fixed solitary nodule;rapid growth(Ominous sign). Accessory examination：calcification;enlargement of neck lymph nodes. 2.Gold standard:path

12、ological examination( fine-needle aspiration biopsy (FNAB).,2020/7/7,.,13,DiagnosisTreatment,Treatment Let General Surgeons do their jobs. The surgical methods differ from cancer types and lymphatic metastasis .,.,14,Central lymph node dissection,functional neck dissection,modified radical neck dissection(MRND),radical neck dissection(RND),Thyroidectomy,DiagnosisTreatment,.,15,THYROID CANCER,1 where is it？ ANATOMY,2 why did it happen？ ETIOLOGY,.,16,Staging Prognosis,.,17,Stag