Thyroid Tumors : Mnemonics

Papillary carcinoma

1. Predominant form
2. Palpable lymph nodes (lymphatic metastasis is common)
3. Positive I¹³¹ uptake
4. Positive prognosis
5. Pops out of capsule (invades capsule)
6. Post-radiation in head and neck, Post-thyroiditis, Polyposis (FAP)
7. Pops everywhere in the gland (multifocal in 20%)
8. Histology: Papillary projections, Pale empty (Orpha annie eye) nuclei, Psammoma bodies, Pseudoinclusions

Follicular carcinoma

1. Fifties females
2. Far-away metastasis (hematogenous)
3. Favorable prognosis
4. Forever alone (solitary nodule)
5. Filled inside capsule (encapsulated macroscopically but invasion seen microscopically – distinguishing feature from follicular adenoma)
6. FNAC futile (cannot distinguish between follicular adenoma and carcinoma)
7. Frozen (cold radionuclide scan)
8. Follicular pattern

Medullary carcinoma

Mnemonic: MENACED

1. MEN 2A and 2B association (RET gene mutation)
2. Multimodal metastases (lymphatic and hematogenous)
3. Amyloid deposition
4. C-cells origin; Calcitonin positive
5. Endocrine tumor (neuroendocrine tumor)
6. Diarrhea and flushing are classic

Anaplastic carcinoma

1. Aggressive
2. Aged females
3. Anaplastic transformation of differentiated thyroid carcinoma
4. All over (local invasion + lymphatic + hematogenous metastasis)