[Surgery of thyroid carcinoma]

Chirurg. 2009 Nov;80(11):1069-82; quiz 1083. doi: 10.1007/s00104-009-1769-x.
[Article in German]

Abstract

The 5 main types of thyroid cancer (papillary, PTC, follicular, FTC, poorly differentiated, PDTC undifferentiated, UTC, medullary, MTC) not only differ regarding morphology, pathogenesis, genetics,and pathophysiology (iodine metabolism, thyroglobulin and calcitonin production), but also concerning tumor biology, metastatic behavior (lymphogenous, locally invasive and hematogenous routes) and prognosis. Knowledge of these features is the basis of the surgical concept of one or two-stage thyroidectomy, the exceptions and the concept of locoregional lymph node dissection. Lymph node surgery plays an important role in those cancers exhibiting mainly lymph node metastases (PTC, MTC) not only due to frequent recurrences but also due to its potential curative intent. Differentiated carcinomas may have an acceptable prognosis despite local invasion of the cervical aerodigestive system, thus resections are justified when technical prerequisites are given.

Publication types

  • English Abstract

MeSH terms

  • Adenocarcinoma, Follicular / diagnosis
  • Adenocarcinoma, Follicular / mortality
  • Adenocarcinoma, Follicular / pathology
  • Adenocarcinoma, Follicular / surgery*
  • Algorithms
  • Biomarkers, Tumor / blood
  • Calcitonin / blood
  • Carcinoma / diagnosis
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Carcinoma, Medullary / diagnosis
  • Carcinoma, Medullary / mortality
  • Carcinoma, Medullary / pathology
  • Carcinoma, Medullary / surgery*
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / mortality
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / surgery*
  • Humans
  • Lymph Node Excision / methods*
  • Lymphatic Metastasis / pathology
  • Microsurgery / methods
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Neoplasm, Residual / diagnosis
  • Neoplasm, Residual / mortality
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / surgery
  • Prognosis
  • Reoperation
  • Survival Rate
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / methods*
  • Trachea / pathology
  • Trachea / surgery

Substances

  • Biomarkers, Tumor
  • Calcitonin