Thyroid cancer

Thyroid cancer most commonly presents as an asymptomatic thyroid nodule detected by palpation or ultrasound in women in their 30s or 40s.

The most important diagnostic test is fine-needle aspiration.

Treatment of differentiated (papillary, follicular) thyroid cancer and Hürthle cell carcinoma depends on pretreatment assessment of risk and usually includes total thyroidectomy or lobectomy. Risk adjustment based on surgical and pathologic findings determines if radioactive iodine ablation, thyroid-stimulating hormone (TSH) suppression, or both is indicated.

Treatment differs and must be tailored for uncommon types of thyroid cancer such as anaplastic, medullary, or primary thyroid lymphoma.

Prognosis depends on risk-group stratification.

Thyroid cancer encompasses a spectrum of pathologic variants that are heterogeneous in clinical behavior. Differentiated follicular cell-derived thyroid cancers (papillary, follicular, Hürthle cell) make up around 90% of cases. Medullary thyroid carcinoma accounts for 3% to 5% of thyroid cancers.[1]Fagin JA, Wells SA Jr. Biologic and clinical perspectives on thyroid cancer. N Engl J Med. 2016 Sep 15;375(11):1054-67. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512163 http://www.ncbi.nlm.nih.gov/pubmed/27626519?tool=bestpractice.com