What is the only benign thyroid neoplasm?
- usually euthyroid
List 2 risk factors for thyroid follicular adenoma.
history of radiation
Follicular carcinoma gender and general age group
Follicular carcinoma route of metastasis and 2 common sites
Anaplastic thyroid carcinoma gender and general age group
What is the most aggressive thyroid carcinoma?
anaplastic thyroid carcinoma
- poorly differentiated
- lethal within 6 months
What thyroid carcinoma arises from parafollicular "C" cells?
medullary thyroid carcinoma
Medullary thyroid carcinoma lab Dx
Is medullary thyroid carcinoma more often sporadic or familial?
sporadic: 80%, mass, middle age
familial: 20%, bilateral, younger age, MEN
- aggressive: 40% 10 year survival
What thyroid carcinoma is associated with amyloid deposits?
medullary thyroid carcinoma
- amyloid deposits of calcitonin
List the 3 P's of MEN-1 Wermer syndrome and the significance of each.
parathyroid hyperplasia or adenoma
pancreatic neuroendocrine tumor
- greatest cause of morbidity, aggressive, multifocal
- most often prolactinoma
List the 3 disorders of MEN-2A Sipple syndrome.
medullary carcinoma of thyroid
List the 3 disorders of MEN-2B.
medullary carcinoma of thyroid (more aggressive than MEN-2A)
neuromas involving GI, skin, eyes, and respiratory tract
What prophylactic procedure is undertaken for RET mutation carriers in MEN-2?
List 3 ways in which PTH increases blood calcium.
Ca2+ mobilization from bones
increased GI absorption
increased reabsorption in kidneys
What 2 branchial pouches give rise to the parathyroid glands?
What mineral and vitamin exhibit feedback inhibition on parathyroid hormone?
calcitriol (active form of vitamin D)
What is the primary cells of the parathyroid glands?
- can turn into oncocytic cells (more eosinophilic cells due to high mitochondria composition)
What are the 2 causes of parathyroid hypofunction?
List 3 s/s of hyperparathyroidism.
What is the most common cause of hyperparathyroidism?
Parathyroid adenoma gender
What is the key distinguishing feature between parathyroid adenoma and hyperplasia in terms of gland involvement?
adenoma: single gland
hyperplasia: all the glands
Is a palpable neck mass more common in parathyroid carcinoma or adenoma?
Describe the capsule, mitotic activity, and nucleoli in parathyroid carcinoma.
Non-neoplastic increase in parenchymal cell mass of multiple parathyroid glands in the absence of a known clinical stimulus for increased secretion of parathyriod hormone
primary parathyroid hyperplasia
Primary parathyroid hyperplasia gender
What is the most common cause of secondary hyperparathyroidism?
- hypocalcemia and hyperphosphatemia
- other causes include dietary deficiency of vitamin D or Ca2+, malabsorption syndromes, tissue resistance to vitamin D, severe hypomagnesemia
What color tumors are associated with osteitis fibrosa cystica?
Parathyroid hyperplasia Rx
total parathyroidectomy with autotransplantation of remnants to neck
What is the most common cause of hypoparathyroidism?
Hypoparathyroidism s/s (3/5)
calcification (paradoxical and unexplained) of basal ganglia, lens
cardiac conduction abnormality