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Câncer de tireoide

Última revisão: 11 Aug 2025
Última atualização: 24 Jan 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • nódulo palpável da tireoide
Detalhes completos

Outros fatores diagnósticos

  • extremidades etárias
  • história familiar de câncer de tireoide
  • rouquidão
  • dispneia
  • disfagia
  • desvio da traqueia
  • linfadenopatia cervical
  • rápido aumento cervical
Detalhes completos

Fatores de risco

  • irradiação da cabeça e do pescoço
  • sexo feminino
  • história familiar de câncer de tireoide
Detalhes completos

Investigações diagnósticas

1st investigations to order

  • hormônio estimulante da tireoide (TSH)
  • ultrassonografia da tireoide/pescoço
  • Aspiração por agulha fina (AAF)
Full details

Investigations to consider

  • teste molecular das amostras de citologia
  • T4 livre
  • T3 livre
  • laringoscopia
  • cintilografia da tireoide com captação de I-123
  • punção por agulha grossa (core biopsy)
  • tomografia computadorizada (TC) do pescoço
  • calcitonina sérica
  • teste genético para síndromes familiares
  • tireoglobulina sérica
Full details

Emerging tests

  • ultrassonografia translaríngea
  • biópsia do linfonodo sentinela

Treatment algorithm

ONGOING

papilar, folicular ou oncocítico

anaplásico

medular

Contributors

Authors

Rajiv Datta, MD, FACS, FRCS, FICS
Rajiv Datta

Chairman

Department of Surgery

Professor Of Surgery, Icahn School of Medicine at Mount Sinai

Chief

Division of Surgical Oncology

Chief

Division of Head and Neck Surgery

Mount Sinai South Nassau Hospital

Oceanside

NY

Disclosures

RD declares that he has no competing interests.

Peer reviewers

Rosemarie Metzger, MD, MPH, FACS

Associate Professor of Surgery, Endocrine Surgery Division

Banner - University Medical Center

Phoenix

AZ

Disclosures

RM declares that she has no competing interests.

Lindsay Bischoff, MD

Associate Professor

Medical Director Vanderbilt Thyroid Center

Vanderbilt University Medical Center

Nashville

TN

Disclosures

LB declares that she has no competing interests.

F. Fausto Palazzo, MS, FRCS

Consultant Endocrine Surgeon

Hammersmith & Charing Cross Hospitals

Clinical Lead for Endocrine Surgery

Honorary Senior Lecturer

Imperial College

London

UK

Disclosures

FFP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Haugen BR, Alexander EK, Bible KC, et al; American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016 Jan;26(1):1-133.Full text  Abstract

Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015 Jun;25(6):567-610.Full text  Abstract

Gharib H, Papini E, Garber JR, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules - 2016 update. Endocr Pract. 2016 May;22(5):622-39.Full text  Abstract

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: thyroid carcinoma [internet publication].Full text

European Society for Medical Oncology. Clinical practice guidelines - thyroid cancer. 2019 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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