Thyroid carcinoma is classified into four types, two of which are benign, namely follicular and papillary tumors , and two malignant, i.e. medullary carcinoma, characterized by a particular genetic configuration and anaplastic tumor . The incidence of the latter is very low (1 in 2000 thyroid cancers), however, being highly malignant, the majority of patients who are affected are not candidates for surgery. This tumor, in fact, is often diagnosed at an advanced stage and due to the characteristics of the cells (it is also called undifferentiated tumor) it develops dizzyingly, with a very rapid evolution that can lead to metastasis over a couple of years.
What causes thyroid cancer?
It is important to know that not only the tumor, but in general any pathology of the thyroid gland , is caused by an iodine deficiency, which together with the intervention of some mutagens triggers the physio-pathological mechanism of the transformation of the thyroid cells from normal to neoplastic, starting with their increase in volume.
How is the diagnosis made?
The diagnosis of thyroid diseases always begins with a physical examination of the thyroid. Thanks to its position, in fact, it is possible to have a first idea on the hardness of the lump, on its mobility and conformation simply thanks to palpation. If the doctor after this first examination deems it necessary to deepen the diagnosis, he will have the patient subjected to ultrasound, which is still the main exam for the diagnosis of thyroid pathologies . It is also recommended to associate the ultrasound examination with the echo-color Doppler, so that the vascularization of the thyroid nodule can be studied: a malignant nodule, in fact, presents an irregular vascularization because the neoplastic cells need a greater blood supply to be able to reproduce. Finally, the doctor may prescribe the needle aspiration to the patient.
The importance of molecular screening
Unfortunately, the diagnosis of the tumor often derives from the occasional finding of the definitive histological examination. However, it would be very useful to know before surgery which subjects are more likely to develop a tumor, so that patients can be operated on when the disease has not yet reached its final stage. For this reason it is fundamental to understand the importance of prevention through molecular screening: with the needle aspiration technique and the following biological study of the cells it is possible to predict the evolution of the pathology of the thyroid. In this way it is therefore possible to carry out an early diagnosis, thanks to which surgery can be recommended to those patients who present the cellular characteristics for tumor development.