What are the clinical manifestations of thyroid cancer?

Written by Chen Xie
Endocrinology
Updated on September 14, 2024
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For patients with thyroid cancer, the most common clinical manifestation is thyroid nodules, and most patients do not have obvious clinical symptoms, only being incidentally discovered during physical examinations. In rare cases, patients may seek medical attention due to enlarged cervical lymph nodes. As the condition progresses, the neck mass gradually enlarges, becomes firmer, and its mobility decreases during swallowing. In some rapid developments, it may invade surrounding tissues, leading to late-stage symptoms such as hoarseness, difficulty breathing, and difficulty swallowing. When the cervical sympathetic nerve is compressed, it can cause pain in the ears, occipital region, and shoulders. In the case of medullary carcinoma, which can produce serotonin and calcitonin, patients may sometimes experience symptoms such as diarrhea, palpitations, facial flushing, or decreased blood calcium levels.

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Late-stage symptoms of thyroid cancer

Differentiated thyroid cancer, in its advanced stages, can exhibit noticeable symptoms due to large nodules or invasion of surrounding organs. For example, a massive nodule pressing on the trachea can cause breathing difficulties, including respiratory distress. Compression of the esophagus can lead to swallowing difficulties, and pressure on the recurrent laryngeal nerve may result in symptoms like hoarseness. Even very few benign thyroid nodules can cause edema and inflammation by compressing these nerves. Therefore, differentiation and distinctive treatment are essential, along with a pathological diagnosis. Medullary thyroid cancer also presents specific symptoms, including persistent diarrhea, endocrine syndromes, and other accompanying conditions such as pheochromocytoma, multiple mucosal neuromas, and symptoms and signs caused by parathyroid adenomas.

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Symptoms of thyroid cancer

The symptoms of thyroid cancer, the first point is the clinical manifestations of differentiated thyroid cancer. Most differentiated thyroid cancers are asymptomatic, with only occasional palpable nodules of varying sizes and textures, which can sometimes be detected in routine physical and imaging examinations. A few advanced thyroid cancers may produce noticeable symptoms due to large nodules or invasion of surrounding organs, such as compression of the trachea causing breathing difficulties, difficulty swallowing due to pressure on the esophagus, and hoarseness due to compression of the recurrent laryngeal nerve. The second point concerns the specific clinical manifestations of medullary thyroid carcinoma. The specific symptoms of medullary thyroid cancer include persistent watery diarrhea, not accompanied by severe malabsorption in the large intestine, often with facial flushing, some endocrine syndromes, and some associated conditions such as pheochromocytoma, multiple mucosal neuromas, and parathyroid adenomas.

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Is there an abnormality in the routine blood test for thyroid cancer?

If you have thyroid cancer, it is advised that patients promptly visit a formal hospital for examination. If one undergoes a routine blood test, generally there will be no abnormalities. This test can reveal the number of platelets, the presence of anemia, or the state of white blood cells, which are not related to the thyroid. Therefore, if thyroid cancer patients undergo routine blood tests, typically no abnormalities will be found. In daily life, patients should ensure they rest sufficiently, engage in less physically demanding exercise, maintain a cheerful mood, plan their three meals a day wisely, and pay attention to nutritious diet planning.

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What are the early symptoms of thyroid cancer?

Thyroid cancer is a common malignant tumor in the head and neck area. The early symptoms of thyroid cancer are highly atypical, and many patients do not present clear early symptoms. Often, patients discover painless nodules in the thyroid incidentally during physical examinations; these nodules can move up and down with swallowing motions. In a minority of cases, when the nodules of early-stage thyroid cancer are large, they can cause hoarseness or coughing and choking when drinking water. Some patients might experience intermittent, hidden pain in the thyroid area during the early stages, which often resolves on its own without treatment. Besides these, in its early stages, thyroid cancer may not present other obvious symptoms. As the condition progresses, significant clinical symptoms appear only when the tumor invades surrounding structures or metastasizes to distant sites.

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Will thyroid cancer spread if surgery is not performed immediately after a biopsy?

Thyroid cancer, after undergoing a fine needle biopsy, may spread if surgery cannot be performed immediately, which is a risk of the thyroid cancer biopsy. Fine needle biopsy of the thyroid is a method for obtaining histopathological results and is a gold standard for the clinical diagnosis of thyroid cancer. A biopsy is an invasive examination that causes some degree of harm to the body, hence, informed consent must be obtained from the patient before proceeding. After the biopsy, complications such as local bleeding, swelling, pain, and infection may occur, and the spread of cancer cells at the biopsy site is a significant adverse effect. Therefore, for most thyroid cancer patients, it is advisable to arrange surgery as soon as possible after a biopsy to prevent the disease from spreading.