Overview

of
THYROID DISEASES

Sunarto Reksoprawiro

Division of Head & Neck Surgery

Department of Surgery
Faculty of Medicine Airlangga University/ Dr. Soetomo Hospital
Surabaya
Anatomy of thyroid gland
Physiology of thyroid gland
 Thyroid Diseases
Physiological disorder Anatomical disorder
– Hypothyroidism – Congenital anomaly
– hyperthyroidism – Hypertrophy – hyperplasia
– Infection
– Autoimmune
– Nodular goiter
– Neoplasm
• Benign
• Malignant
 Congenital anomaly
• Ectopic thyroid
• Thyroid abberant
• Thyroglossal duct cyst
Ectopic thyroid
Lingual thyroid
1/3000 thyroid diseases
Thyroid abberant

-Metastasis thyroid cancer

-Adenoma
-Normal
Thyroglossal duct cyst
 Hypertrophy-hyperplasia
• Struma adolescent
• Struma gravidarum
• Endemic goiter (early phase)
 Infection
• Acute thyroiditis
• Subacute thyroiditis
(de Quervain thyroiditis)
• Chronic thyroiditis
– Hashimoto thyroiditis
– Riedel thyroiditis
Acute thyroiditis, suppurative

S. aureus
S. haemolyticus
Pneumococcus
Subacute thyroiditis
Virus
Hashimoto thyroiditis

Autoimmune disease
•TSH receptor blocking antibody
•Anti-TPO
•Anti-Tg
Riedel thyroiditis

Chronic inflammation

Autoimmune disease
Anti-TPO
Anti-Tg (67%)
Graves disease

Autoimmune disease
Nodular goiter (endemic, sporadic)
Etiology?

Dyshormogenesis (herediter)
Drugs
Goitrogen
Yodine deficiency
Benign neoplasm
Thyroid adenoma: foetal, embryonal, colloid, Hurthle cell
Malignant neoplasm

• Papillary thyroid carcinoma

• Follicular thyroid carcinoma
• Medullary thyroid carcinoma
• Anaplastic thyroid carcinoma
• Others
Papillary carcinoma thyroid

74-80% of thyroid carcinoma

Lymphogen metastases
Good prognose
Follicular carcinoma thyroid

17-20% of thyroid carcinoma

Hematogen metastases
Good prognose
Medullary carcinoma thyroid

4% of thyroid carcinoma
Sporadic (75%), familial (25%)~MEN
Lymphogen & hematogen metastases
Fair prognose

Calcitonin >100 pg/mL

VMA
Anaplastic thyroid carcinoma

2% of thyroid carcinoma
Local aggressive tumor
Hematogen & lymphogen metastases
Bad prognose