The Differences between Thyroiditis, Hyperthyroidism, and Thyroid Cancer

Written by Zhang Li
Endocrinology
Updated on September 19, 2024
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Thyroiditis, hyperthyroidism, and thyroid cancer are clinically distinct conditions. Thyroiditis refers to inflammatory changes in the thyroid, either autoimmunity-related, suppurative or due to inflammation. Hyperthyroidism broadly refers to a functional change, which can result from various thyroid changes caused by diseases, including external damage and inflammation, leading to symptoms of hyperthyroidism. However, these manifestations should not be confused with each other, with the latter more closely related to autoimmune thyroiditis. Thyroid cancer, on the other hand, is a malignant alteration that also occurs in the thyroid gland but is not closely related to thyroiditis or hyperthyroidism. Generally, thyroid cancer is malignant, while thyroiditis and hyperthyroidism are benign, chronic conditions.

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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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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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What are the early symptoms of thyroid cancer?

The most common clinical symptom of thyroid cancer in its early stages is an abnormal lump in the neck. Additionally, some patients may experience symptoms related to abnormal thyroid function. Thyroid cancer is currently a malignant tumor with a relatively high incidence rate globally and in China. There are four pathological types of thyroid cancer: papillary carcinoma, follicular carcinoma, undifferentiated carcinoma, and medullary carcinoma. Among these, papillary carcinoma is the most common and has the best prognosis. For patients presenting with an abnormal neck lump and thyroid function abnormalities, the diagnosis of thyroid cancer should be considered. Diagnosis can be confirmed through tissue obtained by biopsy or surgical excision for pathological examination. For patients with confirmed diagnoses of thyroid cancer, surgery is the preferred treatment method.

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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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How is thyroid cancer diagnosed?

The first point is the diagnostic process for differentiated thyroid cancer. Initially, most patients may not have symptoms, while a minority might show symptoms due to invasion of surrounding organs. Ultrasound examination is the preferred method for diagnosing thyroid nodules. Ultrasound can clarify the number, nature, and location of thyroid nodules, as well as provide information on whether there are abnormally enlarged lymph nodes in the neck. It has a relatively high accuracy in identifying the nature of thyroid nodules. Currently, the most accurate test for determining the nature of thyroid nodules remains the fine needle aspiration cytology, which has a diagnostic sensitivity of 83-92% and specificity of 80-92%, but it is not 100% conclusive. The second point is about the diagnosis of medullary thyroid cancer. Besides the tests common for thyroid cancers, additional tests for medullary thyroid cancer can include fine needle aspiration, ultrasound, and some serological tests, such as calcitonin and carcinoembryonic antigen tests.