PAEA Surgery End Of Rotation (EOR) Practice Exam

Which thyroid cancer has a poor prognosis and is treated with iodine if unresectable?

1. Medullary

2. Papillary

3. Follicular

4. Anaplastic

The correct answer is: Follicular

The correct answer is anaplastic thyroid cancer, which is known for its aggressive behavior and poor prognosis. Anaplastic thyroid cancer often presents in older patients and is characterized by rapid growth, local invasion, and a tendency to metastasize early. Due to these aggressive characteristics, surgical resection is often not possible when the cancer is diagnosed at an advanced stage. In cases where anaplastic thyroid cancer is deemed unresectable, radioiodine therapy can be utilized to help manage the disease. While iodine therapy is more commonly associated with well-differentiated thyroid cancers like papillary and follicular types, anaplastic cancer, despite being poorly differentiated, might still respond to iodine in some circumstances, particularly to palliate symptoms or reduce tumor size, although it is not considered a curative approach. The other types of thyroid cancers mentioned — medullary, papillary, and follicular — typically have better prognoses and more favorable treatment responses. Medullary thyroid cancer does not usually respond to radioactive iodine, as it arises from C-cells and has a different line of treatment. Papillary and follicular thyroid cancers tend to have a good prognosis and are often treated with surgery followed by radioactive iodine if necessary, particularly in cases where