Papillary Thyroid Carcinoma Follow-up

  • Author: Luigi Santacroce, MD; Chief Editor: Jules E Harris, MD   more...
 
Updated: Jan 27, 2012
 

Further Inpatient Care

In patients with papillary thyroid carcinoma (a relatively common well-differentiated thyroid cancer), systematic psychotherapeutic intervention may be very helpful.

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Further Outpatient Care

  • Periodic neck ultrasound is mandatory to monitor the patient status.
  • Perform a postoperative scintiscan of the neck 4-6 weeks after thyroid hormone replacement therapy is completed. At this time, a scan of the neck can help demonstrate if thyroid tissue is still present. If thyroid tissue is present, a dose of radioactive iodine is administered to destroy residual tissue. The patient is then placed back on thyroid hormone replacement (levothyroxine) therapy.
  • Repeat the scintiscan 6-12 months after ablation and, thereafter, every 2 years. Before the scan, levothyroxine must be withdrawn for approximately 4-6 weeks to maximize thyrotropin stimulation of the eventual remaining thyroid tissue.
  • Radioactive iodine may ablate the metastatic tissue in the lungs and bone. These metastases appear to be more amenable to radioiodine therapy than the metastases of papillary carcinoma.
  • Evaluate thyroglobulin serum levels every 6-12 months for at least 5 years. Consider a level greater than 20 ng/mL, after TSH suppression, to be abnormal. A recurrence of thyroid cancer can be detected if a rise in the thyroglobulin level occurs. A study by Brassard et al found that thyroglobulin measurements allow prediction of long-term recurrence with excellent specificity. TSH stimulation may be avoided when thyroglobulin levels measured 3 months after ablation are less than 0.27 ng/mL during levothyroxine treatment.[23]
  • Perform thyroid hormone suppression tests in all patients who have undergone total thyroidectomy and in all patients who have had radioactive ablation of any remaining thyroid tissue. Individualize the degree of suppression to avoid complications, such as subclinical hyperthyroidism.
    • A recent meta-analysis of clinical data from several studies including a large number of subjects demonstrated that an undetectable serum thyroglobulin finding during thyroid hormone suppression of TSH is often misleading. Patients with endogenous subclinical hyperthyroidism have an increased risk of cardiovascular disease and dysrhythmia.[24]
    • Accordingly, the authors propose a new surveillance guideline for patients who have undergone total or near-total thyroidectomy and radioactive iodine ablation and have no clinical evidence of residual tumor with a serum thyroglobulin level less than 1 mcg/L during thyroid hormone suppression of TSH.
    • A study by Miyauchi et al found that serum thyroglobulin doubling-time was a significant prognostic predictor among patients with papillary thyroid carcinoma. The authors concluded that this finding was superior to classical prognostic factors, including TNM stage, age, and gender.[25]
    • The American Thyroid Association Taskforce on Radioiodine Safety released recommendations to help guide physicians and patients in safe practices after treatment, including reminders in the form of a checklist.[26]
  • A patient who has had a thyroidectomy without parathyroid preservation requires vitamin D and calcium supplementation for life.
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Inpatient & Outpatient Medications

  • Any patient with a history of a papillary thyroid carcinoma must have, at 6 and 12 months after the cancer treatment (medical or surgical), a complete physical examination, TSH and thyroglobulin measurement, and antithyroglobulin antibodies titration.
  • If the patient is disease-free, these tests may be performed on annual basis.
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Deterrence/Prevention

No known preventative methods exist.

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Complications

  • If neglected, any thyroid cancer may exhibit symptoms because of compression and/or infiltration of the cancer mass into the surrounding tissues, and the cancer may metastasize to lung and bone.
  • Surgical treatment of thyroid cancer may cause some complications, partially because of the variable anatomy of the neck. These possible complications include the following:
  • Radioiodine administration may have several consequences, including the following:
    • Radiation thyroiditis and transient thyrotoxicosis in patients with simple lobectomy
    • Sialoadenitis because radioiodine is taken up by the salivary glands
    • Nausea, anorexia, and headache (uncommon)
    • Pulmonary fibrosis in patients with large lung metastases
    • Brain edema in patients with brain metastases (may be prevented by glucocorticoid therapy)
    • Permanent sterility and transient oligospermia or menstrual irregularities
    • Teratogenesis and spontaneous abortions
    • A small increase in the risk for leukemias or breast and bladder carcinomas
  • Metastases, in descending order of frequency, are most common in the neck lymph nodes and lung, followed by the bone, brain, liver, and other sites. Metastatic potential seems to be a function of the primary tumor size. Metastases in the absence of thyroid pathology in the physical examination findings are rare in patients with microscopic papillary carcinoma (occult carcinomas).
  • A study by Roh et al found that subclinical metastases are highly prevalent in the ipsilateral central neck of patients with papillary thyroid carcinoma. The findings also revealed that although contralateral central metastases are uncommon they are associated with ipsilateral central metastases. The authors conclude that these findings may suggest the necessity and extent of prophylactic unilateral or bilateral central lymph node dissection.[27]
  • A study by Popadich et al found that the addition of routine central lymph node dissection in patients with cN0 papillary thyroid carcinoma reduced the need for reoperation in the central compartment and was associated with lower postoperative thyroglobulin levels.[28]
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Prognosis

The prognosis of papillary thyroid cancer is related to age, sex, and stage. In general, if cancer is not extending beyond the capsule of the gland, life expectancy is minimally affected. Prognosis is better in female patients and in patients younger than 40 years. The survival rate is at least 95% with appropriate treatments.

In a long-term follow-up study of children and adolescents with papillary thyroid cancer, Hay et al found that all-causes mortality rates did not exceed expectation through 20 years after treatment, but, from 30 through 50 years, the number of deaths was significantly higher than predicted. Nonthyroid malignancy accounted for 68% of deaths, and, of that group, 73% had received postoperative therapeutic irradiation.[29]

A study by Yu et al found that although papillary thyroid microcarcinomas are generally associated with an excellent prognosis; however, 0.5% of patients may die. Risk factors for overall survival include age older than 45 years, male sex, minority race, node metastases, extrathyroidal invasion, and distant metastases. If 2 or more risk factors are present, patients should be considered for more aggressive management.[30]

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Patient Education

  • Patients who discover a neck deformity or thyroid lumps or have a history of prior exposure to ionizing radiation must consult their physician.
  • For excellent patient education resources, visit eMedicine's Endocrine System Center. Also, see eMedicine's patient education article Thyroid Problems.
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Contributor Information and Disclosures
Author

Luigi Santacroce, MD  Assistant Professor, Medical School, State University at Bari, Italy

Disclosure: Nothing to disclose.

Coauthor(s)

Silvia Gagliardi, MD  Consulting Staff, Department of Surgery, Medical Center Vita, Italy

Disclosure: Nothing to disclose.

Andrew Scott Kennedy, MD  Co-Medical Director, Wake Radiology Oncology

Andrew Scott Kennedy, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American Hepato-Pancreato-Biliary Association, American Society for Therapeutic Radiology and Oncology, American Society of Clinical Oncology, and Radiological Society of North America

Disclosure: Nothing to disclose.

Specialty Editor Board

Lodovico Balducci, MD  Professor of Oncology and Medicine, University of South Florida College of Medicine; Division Chief, Senior Adult Oncology Program, H Lee Moffitt Cancer Center and Research Institute

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Rajalaxmi McKenna, MD, FACP  Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems

Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD  Clinical Professor of Medicine, Section of Hematology/Oncology, University of Arizona College of Medicine, Arizona Cancer Center

Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research

Disclosure: GlobeImmune Salary Consulting

References

  1. Wada N, Sugino K, Mimura T, Nagahama M, Kitagawa W, Shibuya H, et al. Treatment Strategy of Papillary Thyroid Carcinoma in Children and Adolescents: Clinical Significance of the Initial Nodal Manifestation. Ann Surg Oncol. Sep 24 2009;[Medline].

  2. Clayman GL, Shellenberger TD, Ginsberg LE, Edeiken BS, El-Naggar AK, Sellin RV, et al. Approach and safety of comprehensive central compartment dissection in patients with recurrent papillary thyroid carcinoma. Head Neck. Sep 2009;31(9):1152-63. [Medline].

  3. Rosenbaum MA, McHenry CR. Contemporary management of papillary carcinoma of the thyroid gland. Expert Rev Anticancer Ther. Mar 2009;9(3):317-29. [Medline].

  4. Pelizzo MR, Merante Boschin I, Toniato A, Pagetta C, Casal Ide E, Mian C, et al. Diagnosis, treatment, prognostic factors and long-term outcome in papillary thyroid carcinoma. Minerva Endocrinol. Dec 2008;33(4):359-79. [Medline].

  5. Thyroid Carcinoma Task Force. AACE/AAES Medical/Surgical Guidelines for Clinical Practice: Management of Thyroid Carcinoma. AACE Guidelines. Available at http://www.aace.com/pub/pdf/guidelines/thyroid_carcinoma.pdf. Accessed December 16, 2009.

  6. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. Thyroid carcinoma. National Comprehensive Cancer Network. Available at http://www.nccn.org/professionals/physician_gls/PDF/thyroid.pdf. Accessed 12/16/2009.

  7. Bradly DP, Reddy V, Prinz RA, Gattuso P. Incidental papillary carcinoma in patients treated surgically for benign thyroid diseases. Surgery. Dec 2009;146(6):1099-104. [Medline].

  8. Kim KW, Park YJ, Kim EH, et al. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck. May 2011;33(5):691-5. [Medline].

  9. Spencer CA. Clinical review: Clinical utility of thyroglobulin antibody (TgAb) measurements for patients with differentiated thyroid cancers (DTC). J Clin Endocrinol Metab. Dec 2011;96(12):3615-27. [Medline].

  10. Rivera M, Tuttle RM, Patel S, Shaha A, Shah JP, Ghossein RA. Encapsulated papillary thyroid carcinoma: a clinico-pathologic study of 106 cases with emphasis on its morphologic subtypes (histologic growth pattern). Thyroid. Feb 2009;19(2):119-27. [Medline].

  11. Mathur A, Moses W, Rahbari R, et al. Higher rate of BRAF mutation in papillary thyroid cancer over time: a single-institution study. Cancer. Oct 1 2011;117(19):4390-5. [Medline]. [Full Text].

  12. American Cancer Society. Cancer Facts and Figures 2008. American Cancer Society. Available at http://www.cancer.org/docroot/STT/content/STT_1x_Cancer_Facts_and_Figures_2008.asp?from=fast. Accessed December 16, 2009.

  13. Ronckers CM, McCarron P, Engels EA, et al. New Malignancies Following Cancer of the Thyroid and Other Endocrine Glands. In: Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr. New Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000. No. 05-5302. Bethesda, MD: NIH Publ.; 2006:375-395. [Full Text].

  14. Negri E, Dal Maso L, Ron E, et al. A pooled analysis of case-control studies of thyroid cancer. II. Menstrual and reproductive factors. Cancer Causes Control. 1999;10(2):143-155. [Medline].

  15. Franceschi S, Preston-Martin S, Dal Maso L, et al. A pooled analysis of case-control studies of thyroid cancer. IV.Benign thyroid diseases. Cancer Causes Control. 1999;10(6):583-595. [Medline].

  16. Mack WJ, Preston-Martin S, Dal Maso L, et al. A pooled analysis of case-control studies of thyroid cancer: cigarettesmoking and consumption of alcohol, coffee, and tea. Cancer. 2003;14(8):773-785. [Medline].

  17. Choi WH, Chung YA, Han EJ, Sohn HS, Lee SH. Clinical value of integrated [18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in the preoperative assessment of papillary thyroid carcinoma: comparison with sonography. J Ultrasound Med. Sep 2011;30(9):1267-73. [Medline].

  18. Segev DL, Umbricht C, Zeiger MA. Molecular pathogenesis of thyroid cancer. Surg Oncol. Aug 2003;12(2):69-90. [Medline].

  19. Liu Z, Kakudo K, Bai Y, et al. Loss of cellular polarity/cohesiveness in the invasive front of papillary thyroid carcinoma, a novel predictor for lymph node metastasis; possible morphological indicator of epithelial mesenchymal transition. J Clin Pathol. Apr 2011;64(4):325-9. [Medline].

  20. Heilo A, Sigstad E, Fagerlid KH, et al. Efficacy of ultrasound-guided percutaneous ethanol injection treatment in patients with a limited number of metastatic cervical lymph nodes from papillary thyroid carcinoma. J Clin Endocrinol Metab. Sep 2011;96(9):2750-5. [Medline].

  21. Yim JH, Kim WB, Kim EY, et al. Adjuvant radioactive therapy after reoperation for locoregionally recurrent papillary thyroid cancer in patients who initially underwent total thyroidectomy and high-dose remnant ablation. J Clin Endocrinol Metab. Dec 2011;96(12):3695-700. [Medline].

  22. Lee S, Ryu HR, Park JH, et al. Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg. Jun 2011;253(6):1060-6. [Medline].

  23. Brassard M, Borget I, Edet-Sanson A, et al. Long-term follow-up of patients with papillary and follicular thyroid cancer: a prospective study on 715 patients. J Clin Endocrinol Metab. May 2011;96(5):1352-9. [Medline].

  24. Vadiveloo T, Donnan PT, Cochrane L, Leese GP. The Thyroid Epidemiology, Audit, and Research Study (TEARS): morbidity in patients with endogenous subclinical hyperthyroidism. J Clin Endocrinol Metab. May 2011;96(5):1344-51. [Medline].

  25. Miyauchi A, Kudo T, Miya A, et al. Prognostic impact of serum thyroglobulin doubling-time under thyrotropin suppression in patients with papillary thyroid carcinoma who underwent total thyroidectomy. Thyroid. Jul 2011;21(7):707-16. [Medline].

  26. [Guideline] Sisson JC, Freitas J, McDougall IR, et al. Radiation safety in the treatment of patients with thyroid diseases by radioiodine ¹³¹i: practice recommendations of the american thyroid association. Thyroid. Apr 2011;21(4):335-46. [Medline].

  27. Roh JL, Kim JM, Park CI. Central lymph node metastasis of unilateral papillary thyroid carcinoma: patterns and factors predictive of nodal metastasis, morbidity, and recurrence. Ann Surg Oncol. Aug 2011;18(8):2245-50. [Medline].

  28. Popadich A, Levin O, Lee JC, et al. A multicenter cohort study of total thyroidectomy and routine central lymph node dissection for cN0 papillary thyroid cancer. Surgery. Dec 2011;150(6):1048-57. [Medline].

  29. [Best Evidence] Hay ID, Gonzalez-Losada T, Reinalda MS, Honetschlager JA, Richards ML, Thompson GB. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg. Jun 2010;34(6):1192-202. [Medline].

  30. Yu XM, Wan Y, Sippel RS, Chen H. Should all papillary thyroid microcarcinomas be aggressively treated? An analysis of 18,445 cases. Ann Surg. Oct 2011;254(4):653-60. [Medline].

  31. AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. American Association of Clinical Endocrinologists. American College of Endocrinology. Endocr Pract. May-Jun 2001;7(3):202-20. [Medline]. [Full Text].

  32. Al-Brahim N, Asa SL. Papillary thyroid carcinoma: an overview. Arch Pathol Lab Med. Jul 2006;130(7):1057-62. [Medline].

  33. Albores-Saavedra J, Wu J. The many faces and mimics of papillary thyroid carcinoma. Endocr Pathol. 2006;17(1):1-18. [Medline].

  34. Arnaldi LA, Borra RC, Maciel RM, et al. Gene expression profiles reveal that DCN, DIO1, and DIO2 are underexpressed in benign and malignant thyroid tumors. Thyroid. Mar 2005;15(3):210-21. [Medline].

  35. Asa SL. My approach to oncocytic tumours of the thyroid. J Clin Pathol. Mar 2004;57(3):225-32. [Medline]. [Full Text].

  36. Baloch ZW, LiVolsi VA. Microcarcinoma of the thyroid. Adv Anat Pathol. Mar 2006;13(2):69-75. [Medline].

  37. Benvenga S. Update on thyroid cancer. Horm Metab Res. May 2008;40(5):323-8. [Medline].

  38. Burman KD. Micropapillary thyroid cancer: should we aspirate all nodules regardless of size?. J Clin Endocrinol Metab. Jun 2006;91(6):2043-6. [Medline].

  39. Chang SH, Joo M, Kim H. Fine needle aspiration biopsy of thyroid nodules in children and adolescents. J Korean Med Sci. Jun 2006;21(3):469-73. [Medline].

  40. Chao TC, Lin JD, Chen MF. Gasless video-assisted total thyroidectomy in the treatment of low risk intrathyroid papillary carcinoma. World J Surg. Sep 2004;28(9):876-9. [Medline].

  41. Clark JR, Lai P, Hall F, et al. Variables predicting distant metastases in thyroid cancer. Laryngoscope. Apr 2005;115(4):661-7. [Medline].

  42. Das DK. Age of patients with papillary thyroid carcinoma: is it a key factor in the development of variants?. Gerontology. May-Jun 2005;51(3):149-54. [Medline].

  43. Del Rio P, Cataldo S, Sommaruga L, et al. The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer?. Minerva Endocrinol. Mar 2008;33(1):1-5. [Medline].

  44. Dimov RS, Deenichin GP, Damianliev RA, et al. Safety and efficacy of modified radical lymph nodes dissection in patients with papillary thyroid cancer and clinically evident lymph nodes metastasis. Folia Med (Plovdiv). 2006;48(1):17-22. [Medline].

  45. Donckier JE, Michel L, Delos M, et al. Interrelated overexpression of endothelial and inducible nitric oxide synthases, endothelin-1 and angiogenic factors in human papillary thyroid carcinoma. Clin Endocrinol (Oxf). Jun 2006;64(6):703-10. [Medline].

  46. Fernandes JK, Day TA, Richardson MS, et al. Overview of the management of differentiated thyroid cancer. Curr Treat Options Oncol. Jan 2005;6(1):47-57. [Medline].

  47. Fraker DL, Skarulis M, Livolsi V. Thyroid tumors. In: DeVita VT Jr, Rosenberg SA, Hellman S, eds. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1997:1629-52.

  48. Furlan JC, Bedard YC, Rosen IB. Role of fine-needle aspiration biopsy and frozen section in the management of papillary thyroid carcinoma subtypes. World J Surg. Sep 2004;28(9):880-5. [Medline].

  49. Grebe SK, Hay ID. Thyroid cancer nodal metastases: biologic significance and therapeutic considerations. Surg Oncol Clin N Am. Jan 1996;5(1):43-63. [Medline].

  50. Haigh PI, Urbach DR, Rotstein LE. Extent of thyroidectomy is not a major determinant of survival in low- or high-risk papillary thyroid cancer. Ann Surg Oncol. Jan 2005;12(1):81-9. [Medline].

  51. Hall P, Adami HO. Thyroid Cancer. In: Adami H, Hunter D, Trichopoulos D, eds. Textbook of Cancer Epidemiology. 2nd ed. New York, NY: Oxford University Press; 2008.

  52. Hay ID, Grant CS, Taylor WF, et al. Ipsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system. Surgery. Dec 1987;102(6):1088-95. [Medline].

  53. Hoang JK, Lee WK, Lee M, et al. US Features of thyroid malignancy: pearls and pitfalls. Radiographics. May-Jun 2007;27(3):847-60; discussion 861-5. [Medline].

  54. Hunt JL, Tometsko M, LiVolsi VA, et al. Molecular evidence of anaplastic transformation in coexisting well-differentiated and anaplastic carcinomas of the thyroid. Am J Surg Pathol. Dec 2003;27(12):1559-64. [Medline].

  55. Jukkola A, Bloigu R, Ebeling T, et al. Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications. Endocr Relat Cancer. Sep 2004;11(3):571-9. [Medline]. [Full Text].

  56. Kakudo K, Tang W, Ito Y, et al. Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group. J Clin Pathol. Oct 2004;57(10):1041-6. [Medline].

  57. Kakudo K, Tang W, Ito Y, et al. Parathyroid invasion, nodal recurrence, and lung metastasis by papillary carcinoma of the thyroid. J Clin Pathol. Mar 2004;57(3):245-9. [Medline].

  58. Khairy GA. Solitary thyroid nodule: the risk of cancer and the extent of surgical therapy. East Afr Med J. Sep 2004;81(9):459-62. [Medline].

  59. Kim S, Wei JP, Braveman JM, et al. Predicting outcome and directing therapy for papillary thyroid carcinoma. Arch Surg. Apr 2004;139(4):390-4; discussion 393-4. [Medline].

  60. Kouvaraki MA, Lee JE, Shapiro SE, et al. Preventable reoperations for persistent and recurrent papillary thyroid carcinoma. Surgery. Dec 2004;136(6):1183-91. [Medline].

  61. Kumagai A, Namba H, Mitsutake N, et al. Childhood thyroid carcinoma with BRAFT1799A mutation shows unique pathological features of poor differentiation. Oncol Rep. Jul 2006;16(1):123-6. [Medline].

  62. Köybasioglu F, Simsek GG, Onal BU. Tall cell variant of papillary carcinoma arising from a thyroglossal cyst: report of a case with diagnosis by fine needle aspiration cytology. Acta Cytol. Mar-Apr 2006;50(2):221-4. [Medline].

  63. La Vecchia C, Ron E, Franceschi S, et al. A pooled analysis of case-control studies of thyroid cancer. III. Oralcontraceptives, menopausal replacement therapy and otherfemale hormones. Cancer Causes Control. 1999;10(2):157-166. [Medline].

  64. Lau WF, Zacharin MR, Waters K, et al. Management of paediatric thyroid carcinoma: recent experience with recombinant human thyroid stimulating hormone in preparation for radioiodine therapy. Intern Med J. Sep 2006;36(9):564-70. [Medline].

  65. Little JW. Thyroid disorders. Part III: neoplastic thyroid disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Sep 2006;102(3):275-80. [Medline].

  66. Liu J, Singh B, Tallini G, et al. Follicular variant of papillary thyroid carcinoma: a clinicopathologic study of a problematic entity. Cancer. Sep 15 2006;107(6):1255-64. [Medline].

  67. Lyshchik A, Drozd V, Demidchik Y, et al. Diagnosis of thyroid cancer in children: value of gray-scale and power doppler US. Radiology. May 2005;235(2):604-13. [Medline].

  68. Mackenzie EJ, Mortimer RH. 6: Thyroid nodules and thyroid cancer. Med J Aust. Mar 1 2004;180(5):242-7. [Medline].

  69. Matsumoto F, Fujii H, Abe M, et al. A novel tumor marker, Niban, is expressed in subsets of thyroid tumors and Hashimoto's thyroiditis. Hum Pathol. Dec 2006;37(12):1592-600. [Medline].

  70. Mazzaferri EL, Robbins RJ, Spencer CA, et al. A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. J Clin Endocrinol Metab. Apr 2003;88(4):1433-41. [Medline].

  71. Endocrine Malignancies. In: Kantarjian HM, Wolff RA, Koller CA, eds. MD Anderson Manual of Medical Oncology. New York, NY: McGraw Hill; 2006:819-54.

  72. Monchik JM, Donatini G, Iannuccilli J, et al. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg. Aug 2006;244(2):296-304. [Medline].

  73. Musholt TJ, Musholt PB, Khaladj N, et al. Prognostic significance of RET and NTRK1 rearrangements in sporadic papillary thyroid carcinoma. Surgery. Dec 2000;128(6):984-93. [Medline].

  74. Musholt TJ, Musholt PB, Petrich T, et al. Familial papillary thyroid carcinoma: genetics, criteria for diagnosis, clinical features, and surgical treatment. World J Surg. Nov 2000;24(11):1409-17. [Medline].

  75. Ng CM, Choi CH, Tiu SC. False-negatives in thyroid nodule aspiration cytology. Hong Kong Med J. Apr 2007;13(2):168-9. [Medline].

  76. Nikiforova MN, Nikiforov YE. Molecular genetics of thyroid cancer: implications for diagnosis, treatment and prognosis. Expert Rev Mol Diagn. Jan 2008;8(1):83-95. [Medline].

  77. Ohmori N, Miyakawa M, Ohmori K, et al. Ultrasonographic findings of papillary thyroid carcinoma with Hashimoto's thyroiditis. Intern Med. 2007;46(9):547-50. [Medline].

  78. Pang HN, Chen CM. Incidence of cancer in nodular goitres. Ann Acad Med Singapore. Apr 2007;36(4):241-3. [Medline].

  79. Port M, Boltze C, Wang Y, et al. A radiation-induced gene signature distinguishes post-Chernobyl from sporadic papillary thyroid cancers. Radiat Res. Dec 2007;168(6):639-49. [Medline].

  80. Ramirez R, Hsu D, Patel A, et al. Over-expression of hepatocyte growth factor/scatter factor (HGF/SF) and the HGF/SF receptor (cMET) are associated with a high risk of metastasis and recurrence for children and young adults with papillary thyroid carcinoma. Clin Endocrinol (Oxf). Nov 2000;53(5):635-44. [Medline].

  81. Richter H, Braselmann H, Hieber L, et al. Chromosomal imbalances in post-chernobyl thyroid tumors. Thyroid. Dec 2004;14(12):1061-4. [Medline].

  82. Riesco-Eizaguirre G, Gutierrez-Martinez P, Garca-Cabezas MA, et al. The oncogene BRAF V600E is associated with a high risk of recurrence and less differentiated papillary thyroid carcinoma due to the impairment of Na+/I- targeting to the membrane. Endocr Relat Cancer. Mar 2006;13(1):257-69. [Medline].

  83. Rios A, Rodriguez JM, Canteras M, et al. Risk factors for malignancy in multinodular goitres. Eur J Surg Oncol. Feb 2004;30(1):58-62. [Medline].

  84. Roh JL, Park JY, Park CI. Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone. Ann Surg. Apr 2007;245(4):604-10. [Medline].

  85. Ron E, Schneider AB. Thyroid Cancer. In: Schottenfeld D, Fraumeni J, eds. Cancer Epidemiology and Prevention. 3rd ed. New York, NY: Oxford University Press; 2006:975-994.

  86. Rosario PW, Fagundes TA, Padrao EL, et al. Total thyroidectomy and lymph node dissection in patients with papillary thyroid carcinoma. Arch Surg. Dec 2004;139(12):1385. [Medline].

  87. Roth LM, Talerman A. The enigma of struma ovarii. Pathology. Feb 2007;39(1):139-46. [Medline].

  88. Ruggieri M, Straniero A, Pacini FM, et al. Video-assisted surgery of the thyroid diseases. Eur Rev Med Pharmacol Sci. Jul-Aug 2003;7(4):91-6. [Medline].

  89. Santacroce L, Luperto P, Fiorella ML, et al. [Carcinoma of unknown origin++ with latero-cervical metastasis. Diagnostic problems. Retrospective analysis of 110 cases of latero-cervical tumefaction]. Clin Ter. May-Jun 2000;151(3):199-201. [Medline].

  90. Scheumann GF, Seeliger H, Musholt TJ, et al. Completion thyroidectomy in 131 patients with differentiated thyroid carcinoma. Eur J Surg. Sep 1996;162(9):677-84. [Medline].

  91. Schlumberger M, Pacini F, Wiersinga WM, et al. Follow-up and management of differentiated thyroid carcinoma: a European perspective in clinical practice. Eur J Endocrinol. Nov 2004;151(5):539-48. [Medline].

  92. Shaha AR. Prognostic factors in papillary thyroid carcinoma and implications of large nodal metastasis. Surgery. Feb 2004;135(2):237-9. [Medline].

  93. Sherman SI, Wirth LJ, Droz JP, Hofmann M, Bastholt L, Martins RG, et al. Motesanib diphosphate in progressive differentiated thyroid cancer. N Engl J Med. Jul 3 2008;359(1):31-42. [Medline].

  94. Shimura H, Haraguchi K, Hiejima Y, et al. Distinct diagnostic criteria for ultrasonographic examination of papillary thyroid carcinoma: a multicenter study. Thyroid. Mar 2005;15(3):251-8. [Medline].

  95. Stephens LA, Powell NG, Grubb J, et al. Investigation of loss of heterozygosity and SNP frequencies in the RET gene in papillary thyroid carcinoma. Thyroid. Feb 2005;15(2):100-4. [Medline].

  96. Sugitani I, Fujimoto Y, Yamamoto N. Papillary thyroid carcinoma with distant metastases: survival predictors and the importance of local control. Surgery. Jan 2008;143(1):35-42. [Medline].

  97. Sugitani I, Kasai N, Fujimoto Y, et al. A novel classification system for patients with PTC: addition of the new variables of large (3 cm or greater) nodal metastases and reclassification during the follow-up period. Surgery. Feb 2004;135(2):139-48. [Medline].

  98. Uruno T, Miyauchi A, Shimizu K, et al. Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer. World J Surg. Apr 2005;29(4):483-5. [Medline].

  99. Wartofsky L, Sherman SI, Gopal J, et al. The use of radioactive iodine in patients with papillary and follicular thyroid cancer. J Clin Endocrinol Metab. Dec 1998;83(12):4195-203. [Medline].

  100. Wasenius VM, Hemmer S, Karjalainen-Lindsberg ML, et al. MET receptor tyrosine kinase sequence alterations in differentiated thyroid carcinoma. Am J Surg Pathol. Apr 2005;29(4):544-9. [Medline].

  101. Williams ED, Abrosimov A, Bogdanova T, et al. Thyroid carcinoma after Chernobyl latent period, morphology and aggressiveness. Br J Cancer. Jun 1 2004;90(11):2219-24. [Medline].

  102. Woodrum DT, Gauger PG. Role of 131I in the treatment of well differentiated thyroid cancer. J Surg Oncol. Mar 1 2005;89(3):114-21. [Medline].

  103. Wreesmann VB, Ghossein RA, Hezel M, et al. Follicular variant of papillary thyroid carcinoma: genome-wide appraisal of a controversial entity. Genes Chromosomes Cancer. Aug 2004;40(4):355-64. [Medline].

  104. Zhu RS, Yu YL, Lu HK, et al. Clinical study of 312 cases with matastatic differentiated thyroid cancer treated with large doses of 131I. Chin Med J (Engl). Mar 5 2005;118(5):425-8. [Medline].

 
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Standard open thyroidectomy.
Table. ACS Estimated New Thyroid Carcinoma Cases and Deaths by Sex, US, 2008[12]
Cases and Deaths Total Males Females
Estimated new cases37,3408,93028,410
Estimated deaths 1,590680910
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