nationale retningslinjer for udredning og behandling af ... - Dahanca
nationale retningslinjer for udredning og behandling af ... - Dahanca
nationale retningslinjer for udredning og behandling af ... - Dahanca
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Thyroideacancer – kliniske <strong>retningslinjer</strong> – marts 2010<br />
FORORD ................................................................................................................................... 5<br />
ARBEJDSGRUPPER .............................................................................................................. 7<br />
INDLEDNING .......................................................................................................................... 8<br />
PATOLOGI ............................................................................................................................ 10<br />
HISTOLOGISKE TYPER ...................................................................................................................... 10<br />
Follikulært karcinom 10<br />
Papillært karcinom 10<br />
Medullært karcinom 11<br />
Lavt differentieret (insular) karcinom 11<br />
Udifferentieret karcinom 11<br />
Andre karcinomer 12<br />
Non-epiteliale tumorer 12<br />
Malignt lymfom 12<br />
Blandede tumorer 12<br />
Sekundære tumorer 12<br />
Uklassificerbare tumorer 12<br />
UDSKÆRING OG BESKRIVELSE ......................................................................................................... 12<br />
TNM-KLASSIFIKATION .................................................................................................... 14<br />
DIAGNOSTISK PROCES VED BEGRUNDET KLINISK MISTANKE OM<br />
THYROIDEACANCER ........................................................................................................ 16<br />
UDREDNINGEN I KRÆFTPAKKE-FORLØB ......................................................................................... 17<br />
KIRURGISK BEHANDLING AF T-POSITION ............................................................... 18<br />
PAPILLÆRE OG FOLLIKULÆRE KARCINOMER (DIFFERENTIEREDE KARCINOMER) ..................... 18<br />
Pr<strong>og</strong>nostiske faktorer <strong>og</strong> lavrisik<strong>og</strong>ruppe 18<br />
Papillære mikrokarcinomer 19<br />
MEDULLÆRE KARCINOMER ............................................................................................................. 19<br />
UDIFFERENTIERET (ANAPLASTISK) THYROIDEAKARCINOM .......................................................... 19<br />
ANDRE CANCERTYPER ...................................................................................................................... 20<br />
KIRURGI I RELATION TIL NÆRLIGGENDE STRUKTURER PÅ HALSEN ............................................. 20<br />
Glandulae parathyroideae 20<br />
Nervus laryngeus recurrens <strong>og</strong> nervus laryngeus superior 20<br />
KIRURGI VED INDVÆKST I LARYNX/TRACHEA/OESOPHAGUS ........................................................ 20<br />
KIRURGISK BEHANDLING AF N-POSITION ............................................................... 22<br />
PAPILLÆRT KARCINOM .................................................................................................................... 22<br />
FOLLIKULÆRT KARCINOM ............................................................................................................... 22<br />
MEDULLÆRT KARCINOM .................................................................................................................. 22<br />
UDIFFERENTIERET KARCINOM ......................................................................................................... 23<br />
KARCINOM SOM TILFÆLDIGT FUND I FORBINDELSE MED HEMITHYROIDEKTOMI ....................... 23<br />
SUSPEKT FNA .................................................................................................................................... 23<br />
OPERATIONSKOMPLIKATIONER ................................................................................. 24<br />
POSTOPERATIV HYPOCALCÆMI ....................................................................................................... 24<br />
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