The thyroid is a butterfly-shaped endocrine gland located at the front of the neck region and consists of two lobes, right and left, joined by a narrow bridge called the isthmus.
It has a follicular structure and has two endocrine components producing:
- thyroid hormones (T3 and T4) stored in the follicles
- calcitonin produced by C cells or parafollicular
Thyroid hormones regulate many body functions including metabolism, heart rate and body temperature while calcitonin regulates bone resorption.
Hormone production is controlled in turn by the release of another hormone, TSH (thyroid stimulating hormone), produced by the pituitary located in the brain. In the event of illness, the hormone is produced in excess (hyperthyroidism) or vice versa in deficient quantities (hypothyroidism).
Throughout life, the thyroid gland may experience pathological processes of an inflammatory basis (thyroiditis), a degenerative basis (goiter) and, albeit more rarely, a neoplastic basis (cancer).
Thyroid cancers are divided into the following:
– Papillary adenocarcinomas (over 75% of cases)
– Follicular adenocarcinomas (about 15%)
– Medullary carcinomas (less than 5% of cases)
– Anaplastic carcinomas (less than 1% of thyroid cancers)
Thyroid cancer incidence, currently estimated at about 3,600 cases per year in Italy, is undergoing significant growth. This phenomenon is attributed to the increased number of early stage diagnosis using ultrasound screening. Fortunately, the mortality rate is very low and tends to decrease as more than 90% of thyroid cancers are cured with administered treatments.
Women are more affected than men in the proportion of four to one.
- a goiter, characterized by numerous benign nodules of the gland due to iodine deficiency, can in some cases risk a malignant transformation of the cells
- radiation exposure. Thyroid cancer is more common in people who have been treated for other cancers with radiation therapy in the neck, or who have been exposed to radioactive material fallout (it happened after the explosion of the atomic bombs in World War II and after the disaster at the Chernobyl nuclear power plant)
- medullary thyroid carcinoma may be associated with a syndrome called multiple endocrine neoplasia type 2 (or MEN 2) that has a genetic basis, so those affected can have other family members who suffer from thyroid cancer or adrenal gland cancer (pheochromocytoma).
- For this reason, family members of these people are invited to undergo specialist examinations and blood tests to rule out the presence of this disease.
SIGNS and SYMPTOMS
Nodule: the most common symptom is the appearance of a nodule. Not all thyroid nodules are cancers; instead, they are often a sign of inflammation (thyroiditis) and degeneration (goiter). It is estimated that less than 5% of thyroid nodules actually hides a tumor.
The thyroid nodule, single or multiple, can be evaluated by a physical examination when it reaches a certain volume, but it is often not visible nor palpable even by a medical expert.
Non-palpable nodules can be identified and located by an ultrasound examination. The rate of thyroid nodules that are not clinically noticeable in the normal population, detectable by ultrasound examination, is high, varying in published cases from 20% to 76%. In most cases, non-palpable nodules have benign ultrasound characteristics; they take effect asymptomatically and only require checkups every once in a while.
In other cases, the ultrasound characteristics suggest a diagnostic study with findings that include:
- needle aspiration cytological exam
- a dosage of thyroid hormones
- thyroid scintigraphy for the functional evaluation of the nodule and thyroid.
Not rarely do these investigations, while excluding the presence of tumors, indicate a state of reduction or excess of thyroid gland function that can be restored with appropriate medical therapy.
The ANT THYROID PROJECT aims to identify people with nodules by performing an ultrasound examination. The early diagnosis of a thyroid nodule allows for an intervention in the most appropriate and timely way possible with further laboratory, instrumental and biopsy examinations.
Checkups are performed by appointment at the clinics listed below. They are free of charge thanks to funds / resources / donations that the Foundation is able to devote to this sector.
- ANT Institute in Bologna
- ANT delegations in Brescia, Pesaro, Porto S Elpidio
- around the country offered for free by ANT