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Revista Portuguesa de Saúde Ocupacional online

versão impressa ISSN 2183-8453

Resumo

SALDANHA, N et al. THYROID CARCINOMA: DIAGNOSIS IN OCCUPATIONAL MEDICINE HEALTH EXAMINATION AND SHIFT WORK APTITUDE. RPSO [online]. 2022, vol.13, pp.116-121.  Epub 21-Jul-2022. ISSN 2183-8453.  https://doi.org/10.31252/rpso.14.05.2022.

Introduction

Thyroid carcinomas include a wide spectrum of lesions. The well-differentiated subtype, 90% of all thyroid cancers, is associated with an excellent prognosis. Several risk factors are described. The most important environmental factor is exposure to ionizing radiation, although shift work is proposed as a prominent factor. The common clinical presentation of thyroid carcinoma is a thyroid nodule detected by the patient or imaging tests.

Case Report

This is a 25-year-old nurse who came to the occupational health service with complaints of enlarged cervical nodes. She denied prominent personal background. She had a palpable mass in the thyroid and right supraclavicular region and dysphonia with six to nine months of evolution. She underwent cervical ultrasound with biopsy that revealed papillary thyroid carcinoma with lymph node metastasis. She had surgery and radioactive iodine treatment. In occupational health, she was conditioned to shift work.

Discussion

Surgical removal and radioactive iodine treatment cures more than 90% of localized and well-differentiated thyroid carcinomas. Well-differentiated thyroid carcinoma with metastases is associated with a 90% ten-year survival if there is good iodine supply and the tumor goes into remission after treatment. A relationship between circadian cycle dysfunction and thyroid carcinoma is proposed, so it is important to decide the ability to work at night in the follow-up period of the disease.

Conclusion

The relevance of the case arises with the aim of alerting to the advantages of an Occupational Health service and its ability to provide a timely and rapid response to various pathologies of the working population with important health gains. This case also offers a rationale for the management and time of shift work avoidance in the post-diagnosis of thyroid carcinoma.

Palavras-chave : thyroid carcinoma; shift work; occupational medicine; occupational health..

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