Prof. Dr. Ahmet Özdoğan

Reference

Medical Dictionary

300 ENT terms selected from a 3,008-entry working corpus. Entries are readable; organic publication requires documented medical review.

Medical review is in progress

These 300 entries are accessible for information. Entries without documented medical sign-off remain excluded from search indexing and entry-level medical structured data.

Thyroid & Parathyroid

78 selected terms

Thyroglobulin Monitoring in Thyroid Cancer

Recurrence marker used in differentiated thyroid cancer follow-up after total thyroidectomy and RAI ablation; interpretation complicated by TgAb presence, stimulated Tg is superior to suppressed Tg.

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Whole-Body Scintigraphy (WBS)

Nuclear medicine method using I-131 or I-123 to evaluate residual thyroid tissue and suspected distant involvement during differentiated thyroid malignancy review.

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PET-CT in Thyroid Cancer Follow-up

The role of FDG-PET/CT in interpreting suspected RAI-resistant disease and dedifferentiation in differentiated thyroid malignancy; one advanced imaging option when Tg is high but WBS is negative.

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Thyroid Cancer Staging

Thyroid cancer classification according to the AJCC/TNM staging system; age threshold, different T/N/M criteria by pathological subtype and critical role in prognosis prediction.

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Neck Dissection in Thyroid Cancer

Surgical removal of central or lateral neck lymph nodes in metastatic or high-risk thyroid cancer, planned according to confirmed nodal disease and risk level.

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TSH Suppression Therapy

Levothyroxine strategy that suppresses TSH in differentiated thyroid cancer to reduce recurrence risk while balancing cardiac and bone side effects.

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Thyroid Molecular Testing

Molecular diagnostic platforms helping determine malignancy risk with BRAF, RAS, RET/PTC, PAX8/PPARG mutations and gene expression classifiers (Afirma, ThyroSeq) in Bethesda III-IV indeterminate thyroid nodules.

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RET Proto-Oncogene

RET proto-oncogene mutations strongly associated with medullary thyroid carcinoma and MEN 2A/2B syndromes; germline RET results influence family screening and prophylactic-surgery timing.

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BRAF V600E Mutation in Thyroid Cancer

BRAF V600E mutation can be seen in papillary thyroid carcinoma; it may be associated with more aggressive histology, extrathyroidal extension and RAI resistance and is a target for inhibitor therapy.

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Parathyroid Glands

Four small endocrine glands located on the posterior surface of the thyroid gland, secreting PTH to regulate calcium-phosphate balance; their preservation is critically important in thyroid surgery.

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Hyperparathyroidism

Endocrine disorder developing from excessive PTH secretion from parathyroid glands, causing hypercalcemia, kidney stones, bone erosion and neuropsychological symptoms; primary, secondary and tertiary types exist.

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Parathyroid Adenoma

Benign tumor of a single parathyroid gland and one of the most common causes of primary hyperparathyroidism; localization imaging and surgical options are reviewed together.

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Secondary Hyperparathyroidism

Reactive PTH increase developing due to chronic kidney disease, vitamin D deficiency or malabsorption; surgical options may be discussed in advanced cases resistant to medical therapy.

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Thyroid Ultrasound and TI-RADS Classification

Thyroid ultrasound categorises nodules by the ACR TI-RADS 2017 system into risk categories TR1–TR5; TR4 (≥3 points) and TR5 (≥7 points) nodules are evaluated against size-based biopsy thresholds.

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Medullary Thyroid Carcinoma

Medullary thyroid carcinoma (MTC) is a neuroendocrine tumour arising from parafollicular C cells that secretes calcitonin, representing 3–5% of thyroid cancers; 25% of cases are hereditary (MEN2A/2B or familial MTC).

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Thyroid Fine-Needle Aspiration Biopsy — Technique

Ultrasound-guided thyroid fine-needle aspiration biopsy (FNA) uses a 25G needle to obtain cellular specimens from nodules; diagnostic adequacy is approximately 90%, and it is the standard diagnostic method per ATA 2015 and ETA guidelines.

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Thyroid Scintigraphy

Thyroid scintigraphy using Tc-99m pertechnetate or I-123 provides functional thyroid imaging; it identifies 'hot' (hyperfunctioning) nodules, differentiates Graves' disease from toxic multinodular goitre, and is used for RAI treatment dose calculation.

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Complications of Thyroid Surgery

Major complications of thyroid surgery include recurrent laryngeal nerve (RLN) palsy (0.5–2% permanent), hypoparathyroidism (1–3% permanent), and haemorrhage (<1%); surgeon experience is the dominant determinant of these rates.

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Reoperative Thyroid Surgery

Reoperative thyroid surgery is performed in patients with prior thyroid operations for residual or recurrent disease and carries complication rates 2–3 times higher than primary surgery.

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Total Thyroidectomy vs. Lobectomy: Decision Criteria

ATA 2015 guidelines state that lobectomy is an acceptable alternative to total thyroidectomy for 1–4 cm papillary or follicular carcinoma without contralateral involvement, extrathyroidal extension, RAI requirement, or nodule >4 cm.

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Thyroid Hormone Replacement Therapy

Thyroid hormone replacement targets TSH within the reference range (0.5–4.5 mIU/L) using synthetic levothyroxine (LT4) as standard therapy for hypothyroidism; dosing must be individualised by age, weight, and comorbidities.

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Radioiodine-Refractory Differentiated Thyroid Cancer

Radioiodine-refractory DTC (RAI-refractory DTC) is defined by loss of I-131 uptake or lack of response to RAI therapy; kinase inhibitors such as sorafenib or lenvatinib are the standard of care in this setting.

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Thyroid Nodule Surveillance Protocol

ATA 2015 and ACR TI-RADS 2017 guidelines define thyroid nodule surveillance by risk category: TR5/high suspicion annually, TR4/intermediate 1–2 yearly, TR3/low suspicion every 2–3 years, and TR1–2/very low suspicion may not need follow-up beyond 5 years.

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Types and Classification of Thyroiditis

Thyroiditis is a heterogeneous group of inflammatory thyroid conditions encompassing autoimmune (Hashimoto's, Graves'), subacute granulomatous (De Quervain's), silent/postpartum, drug-induced (amiodarone, lithium, checkpoint inhibitors), and acute suppurative thyroiditis subtypes.

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Autoimmune Thyroiditis

Autoimmune thyroiditis describes a group of diseases characterised by chronic lymphocytic inflammation of the thyroid mediated by thyroid antibodies (TPOAb and/or TgAb); Hashimoto's thyroiditis (atrophic or goitrous) and Graves' disease are the primary forms.

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TSH Interpretation

Thyroid-stimulating hormone (TSH) is the single most sensitive indicator of thyroid function; the reference range is 0.4–4.0 mIU/L, but interpretation varies by age, pregnancy, and clinical context.

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Free T4 and T3 Interpretation

Free T4 (FT4) reference range is 0.8–1.8 ng/dL (10–23 pmol/L) and free T3 (FT3) is 2.3–4.2 pg/mL (3.5–6.5 pmol/L); interpreted alongside TSH they differentiate pathology at all levels of the thyroid axis.

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Thyroid Antibody Interpretation

Thyroid antibodies are evaluated in three main groups — TPOAb (thyroid peroxidase antibody), TgAb (thyroglobulin antibody), and TRAb (TSH receptor antibody) — and guide diagnosis, risk stratification, and treatment decisions in autoimmune thyroid disease.

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Thyroglobulin — Thyroid Cancer Surveillance Marker

Thyroglobulin (Tg) is the primary surveillance biomarker for differentiated thyroid cancer (DTC) after total thyroidectomy and RAI ablation; stimulated Tg >1 ng/mL or basal Tg >0.2 ng/mL (under LT4 suppression) raises suspicion of structural recurrence.

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Thyroid Cancer Recurrence

Recurrence in differentiated thyroid cancer (DTC) occurs cumulatively in 10–30% over 20 years after surgery and RAI; cervical lymph node recurrence is most common (80%), distant metastasis recurrence (20%) is less frequent but demands aggressive management.

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Neck Dissection in Thyroid Cancer

In differentiated thyroid cancer, neck dissection is planned as compartment-based central (Level VI) or lateral (Level II–V) based on the spread pattern; prophylactic central dissection remains controversial while therapeutic dissection is standard for imaging-positive lymph nodes.

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Pharmacology of Hyperthyroidism

Pharmacological treatment of hyperthyroidism uses thionamides (methimazole, propylthiouracil) to block thyroid hormone synthesis; beta-blockers provide symptomatic control and serve as bridging therapy until definitive treatment (RAI or surgery) is planned.

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Parathyroid Adenoma

Parathyroid adenoma is the most common cause of primary hyperparathyroidism (85–90% of cases); it is defined by elevated PTH and calcium, and parathyroidectomy is recommended in symptomatic patients or when calcium exceeds ULN by >1 mg/dL.

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Parathyroid Hormone (PTH) Interpretation

Intact PTH (iPTH) reference range is 15–65 pg/mL (1.6–6.9 pmol/L); interpreted alongside calcium levels, it differentiates parathyroid axis disorders including hyperparathyroidism, hypoparathyroidism, and pseudohypoparathyroidism.

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Calcium Regulation

Normal serum calcium range is 8.5–10.5 mg/dL (2.12–2.62 mmol/L); it is tightly regulated through a negative feedback mechanism involving PTH, calcitriol (active vitamin D), and calcitonin.

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Treatment of Hypoparathyroidism

The cornerstone of hypoparathyroidism treatment is oral calcium (1.5–3 g/day) combined with active vitamin D (calcitriol 0.25–2 mcg/day); serum calcium is maintained at 8.0–9.0 mg/dL with urinary calcium <300 mg/day to prevent nephrocalcinosis.

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Thyroid Volume Calculation

Thyroid volume is calculated by ultrasound using the ellipsoid formula: length × width × depth × 0.479 for each lobe (Brunn formula); normal adult thyroid volume is <25 mL in men and <18 mL in women.

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Endoscopic Ultrasound of the Thyroid Nodule

Endoscopic ultrasound (EUS) is an advanced imaging and sampling technique that enables diagnostic biopsy of thyroid nodules or lymph nodes with retrooesophageal or mediastinal extension where transcervical access is limited.

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Thyroglossal Duct Cyst

A thyroglossal duct cyst is a congenital cystic lesion arising from a persistently patent duct remaining from embryonic thyroid migration (from the foramen caecum to the thyroid bed); it is the most common midline neck cyst (75%) in children and young adults.

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