Thyroid Tumour

Diagnosis

The diagnosis of thyroid cancer can be made with the following methods:

• Medical history and physical examination: An individual will have to undergo a comprehensive health examination to determine the probable causes of their symptoms. Your healthcare professional may seek detailed information about the occurrence and progression of symptoms. The patients are also asked about their medical as well as family history. If the doctor suspects thyroid cancer, he/she may recommend the patient undergo further tests.
• Blood tests: Although blood tests cannot diagnose thyroid cancer, these tests may provide crucial information about the functional status of the thyroid gland. Any thyroid gland dysfunction alters the level of several hormones in the blood. Blood tests determine the levels of thyroid stimulating hormone, T3 and T4 hormones, calcitonin, and thyroglobulin. People with medullary thyroid cancer may also have elevated levels of carcinoembryonic antigen that may also be detected with a blood test.
• Radioiodine scanning: The patients may undergo a radioactive scan to diagnose thyroid cancer and to determine its spread to other tissues. In this test, the patients are advised to swallow a pill that contains a safe dose of radioactive iodine or injected with radioactive iodine in their veins. After a few hours, the radioactive iodine is absorbed by the thyroid gland. A special camera then measures the radioactivity in the tissues. The area with less radioactivity (cold nodules) can be benign or cancerous. Further, the radioactivity is also traced in the complete body. The tissues where the thyroid cancer has spread may be detected by detecting radioactivity. This method is not used for diagnosing medullary thyroid cancer, as these cells cannot absorb iodine.
• Genetic tests: The patients may also have to undergo genetic testing based on their family history.
• Ultrasound: It is an ideal imaging technique for diagnosing and evaluating thyroid nodules. The role of ultrasound in thyroid cancer includes diagnosing and characterizing the thyroid tumor, monitoring patients after treatment, and providing assistance during biopsy (ultrasound-guided biopsy).
• CT scan: The patients may undergo CT scans to determine the size and locations of thyroid cancer. The scan also assists in detecting the organs and tissues to which the thyroid cancer may have spread. However, oncologists usually prefer MRI over CT because the contrast dye used in the CT scan may interfere with the results of radioiodine scans.
• MRI: Ultrasound is usually the choice for imaging for the preliminary diagnosis and monitoring of thyroid cancer. However, MRI is preferred over ultrasound due to its higher soft-tissue resolution in cases with a high risk of recurrence or relapse. Advanced MRI can help in differentiating between malignant and benign thyroid lesions. It also allows the evaluation of the spread of the tumor to surrounding tissues.
• PET scan: PET scan is usually performed when there is a high suspicion of thyroid cancer, but it is not detected through a radioactive iodine test. These cases include the presence of medullary thyroid cancer.
• Chest x-ray: The cancer specialists may advise the patient for a chest x-ray to rule out the spread of thyroid cancer to the lungs, especially when the patient has pulmonary symptoms.
• Laryngoscopy: The patients may also undergo laryngoscopy to evaluate the impact of thyroid cancer on the vocal cords. It involves examining the voice box with a laryngoscope, a long, thin tube with a video camera at the end.
• Biopsy: Biopsy is performed to confirm the presence of thyroid cancer. During a biopsy, the oncologist obtains a thyroid tissue sample and sends it to the laboratory for detailed cellular evaluation. Sentinel node biopsy involves taking the sample from the nearby lymph nodes.