Thyroid Cancer: Diagnosis, Treatment and Follow-Up

Abstract

Thyroid cancer is the most common malignancy of the endocrine system and it is usually presented as nodular goiter, the last being extremely a common clinical and ultrasound finding. The widespread use of ultrasonography during the last decades has resulted in a dramatic increase in the prevalence of clinically inapparent thyroid nodules, which only in 5.0–10.0% harbor thyroid carcinoma. The goal of the initial sonographic assessment of thyroid nodules is to distinguish benign nodules that could be managed conservatively from those with suspicious or malignant features requiring further management, including fine needle aspiration biopsy (FNAB), some axillary molecular techniques and thyroid surgery. Since over 90% of malignant thyroid nodules are differentiated thyroid carcinomas (DTCs) with good prognosis, it is necessary to establish strict criteria for diagnosis, treatment and follow-up in order to minimize the potential harm of over-treatment of low-risk patients and to provide adequate therapy to patients at high risk. This often requires an interdisciplinary approach involving endocrinologists, surgeons, pathologists, radiologists and oncologists.