Differentiated thyroid cancer is a common malignancy with an excellent prognosis. Patients typically present with a thyroid nodule identified on physical exam or imaging. Fine needle aspiration (FNA) is the diagnostic modality of choice; ultrasound of the neck is used preoperatively to evaluate lymphadenopathy. Surgery is the mainstay of treatment, with partial or total thyroidectomy (with or without lymphadenectomy). Intra-operatively, identification of the recurrent laryngeal nerve and preservation of the parathyroid glands is imperative. Postoperatively, patients are considered for adjuvant radioactive iodine ablation. Risk stratification systems are available to assist patient selection for therapy. Surveillance is completed with serial physical exams, laboratory studies, ultrasound, and radioactive iodine scanning. Recurrence can be managed with surgery, thyroid-stimulating hormone suppression, radioactive iodine ablation, radiation, or kinase inhibitors.
This review contains 8 figures, 6 tables, and 50 references.
Key Words: Bethesda classification, differentiated thyroid cancer, follicular thyroid cancer, papillary thyroid cancer, radioactive iodine, thyroid nodule, thyroidectomy
Influence of the first radioactive iodine ablation on peripheral complete blood count in patients with differentiated thyroid cancer