Surgery Thyroid Diseases for UPSC CMS: Goitre, Thyroiditis and Thyroid Cancer Classification

Goitre Classification#

Diffuse: Entire gland enlarged. Graves disease (hyperthyroid), Hashimoto (hypothyroid).
Multinodular: Multiple nodules. Most common thyroid disease.
Solitary nodule: Single nodule. 10-20% malignant risk.

Thyroiditis#

• Hashimoto: Anti-TPO, Anti-thyroglobulin. Painless goitre -> hypothyroidism.
• De Quervain: Painful goitre, elevated ESR. Usually post-viral. Self-limiting.
• Subacute (silent): Painless, post-partum. May cause transient hyper -> hypo -> recovery.

Thyroid Cancer Types#

Papillary (80%): Slow-growing, lymph node spread. Treatment: total thyroidectomy + radioiodine.
Follicular (10%): Hematogenous spread (bone, lung). Need total thyroidectomy.
Medullary: Calcitonin elevated. RET mutation (MEN2). Prophylactic thyroidectomy if RET+.
Anaplastic (1%): Very aggressive, elderly. Poor prognosis.