Papillarschilddrüsenkarzinom (PTC)
Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.
| ID | DIS-THYROID-PAPILLARY |
|---|---|
| Art | Erkrankung |
| Aliase | PTCPapillarschilddrüsenkarzinomПапілярна карцинома щитовидної залози |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Erkrankungen | None declared |
| Quellen | SRC-NCCN-CNS-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8260/3 |
|---|---|
| icd_o_3_topography | ["C73"] |
| icd_10 | C73 |
| who_classification | WHO Endokrine Tumore 5 ed (2022): Papillarschilddrüsenkarzinom (follikulärer Zellherkunft) |
Anmerkungen
Differentiated thyroid carcinoma — most indolent of common cancers. Standard care: surgery → risk-stratified RAI ablation → TSH suppression → calibrated thyroglobulin (Tg) monitoring. Radioiodine-refractory progressive disease is the trigger for systemic therapy: - Multikinase TKI 1L: lenvatinib (SELECT) or sorafenib (DECISION). - Targeted by genotype: * BRAF V600E (~50% PTC): dabrafenib + trametinib (MARCH/REINK compassionate-use; FDA tumor-agnostic 2022 BRAF V600E approval for solid tumors); single-agent dabrafenib also active. * RET fusion: selpercatinib (LIBRETTO-531; positive 2024) and pralsetinib (ARROW) — selpercatinib FDA-approved for RET-fusion+ thyroid cancer. * NTRK fusion: larotrectinib / entrectinib (tumor-agnostic). * Re-differentiation strategies: short-course MAPK inhibitor (selumetinib / dabrafenib + trametinib) restoring RAI uptake — under study. Aggressive variants (tall cell, hobnail, columnar, diffuse sclerosing) upstage to higher recurrence-risk groups even when small.
Verwendet von
Therapeutische Relevanz
BMA-NTRK-FUSION-THYROID-PAPILLARY- NTRK Fusion im papillary Schilddrüsenkarzinom (~1-2% sporadisch, höher in strahleninduzierten d...BMA-RET-FUSION-THYROID-PAPILLARY- RET fusion in papillary thyroid carcinoma (PTC) — ~5-10% sporadic, enriched in radiation-...BMA-TERT-THYROID- TERT-Promotor-Mutationen (C228T oder C250T) treten bei ~10–15% des papillaren Schilddrüsenkrebses (PT...
Algorithmen
ALGO-THYROID-PAPILLARY-1L- ALGO-THYROID-PAPILLARY-1L
Erkrankung
DIS-MTC- Medullary Schilddrüsenkarzinom (MTC)DIS-THYROID-ANAPLASTIC- Anaplastisches Schilddrüsenkarzinom (ATC)
Anwendungsgebiet
IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-OBSERVATION- IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-OBSERVATIONIND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-SURVEILLANCE- IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-SURVEILLANCEIND-THYROID-PAPILLARY-RAI-REFRACTORY-LENVATINIB- IND-THYROID-PAPILLARY-RAI-REFRACTORY-LENVATINIB
Fragebogen
QUEST-THYROID-PAPILLARY-1L-STUB- papillares Schilddrüsenkarzinom — erste Zeile
Warnhinweis
RF-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION- Hashimotos Schilddrüsenentzündung (chronische autoimmune lymphatische Schilddrüsenentzündung, positive Anti-TPO und...RF-COWDEN-CONFIRMED-CARRIER- Bestätigte keimlinienpathogene / wahrscheinlich-pathogene Variante im PTEN-Gen (Cowden syndro...RF-COWDEN-FAMILY-HISTORY-SUSPICION- Familienahnen, die auf das Cowden-Syndrom / PTEN-Hammartom-Tumor-Syndrom (PHTS) hinweisen:...RF-OCC-IONIZING-RADIATION-PREVENTION- dokumentierte historische berufliche Exposition gegenüber ionisierender Strahlung - typische Hochrisiko-Occ...RF-THYROID-PAPILLARY-FRAILTY-AGE- Alter ≥ 75 Jahre mit ECOG ≥ 2 oder ≥ 2 Komorbiditäten — Lenvatinib-Volldosis (24 mg) schlecht vertragen;...RF-THYROID-PAPILLARY-HIGH-RISK-BIOLOGY- Papillary thyroid carcinoma with adverse molecular / clinical features: BRAF V600E (~60%...RF-THYROID-PAPILLARY-INFECTION-SCREENING- Aktive oder latente Infektion, die Auflösung / Prophylaxe vor Beginn der Lang-Dura-...RF-THYROID-PAPILLARY-ORGAN-DYSFUNCTION- Ausgangsorganfunktionsstörungen, die Standard-Lenvatinib / Sorafenib-Multikinase hemmen...RF-THYROID-PAPILLARY-TRANSFORMATION-PROGRESSION- PTC-Transformation in anaplastische Schilddrüsenkarzinom-Komponente (DTC→ATC-Dedifferenzierung...RF-WERNER-CONFIRMED-CARRIER- Bestätigte biallelic keimlinien-pathogene / wahrscheinlich-pathogene Varianten in WRN (RECQL2; Wern...