Thyroid cancer classification, clinical features, diagnosis and therapy

Abstract

The topic of thyroid cancer has been highly controversial in all its aspects, but most of all in its histologic classification and its management. The present section is an attempt to crystallize the vast literature in this area. The histology and the ultrastructure of thyroid tumors is discussed. The etiologic factors involved in the development of thyroid cancer are largely unknown; the high incidence of thyroid cancer in Hawaii points to important environmental factors causing malignancies in the thyroid. The importance of radiation to the neck area in childhood is another recognized etiologic factor in the development of thyroid tumors. Isotope scanning techniques are discussed. Ultrasonography is useful for the diagnosis of cystic lesions of the thyroid. Finally the variable surgical procedures used by various authors in the management of differentiated thyroid cancer is reviewed; the rationale for performing a total thyroidectomy in these cases, as advocated by the authors, is discussed. The use of radioiodine therapy following surgery', treatment with suppressive doses of thyroid hormone and the use of adriamycin as a treatment for thyroid cancer uncontrollable by other means are discussed.