[Thyroid carcinoma. Diagnosis--nonoperative therapy--after care]

Thyroid carcinomas may originate in the thyroid cells (follicular and papillary, carcinoma, so-called differentiated carcinomas, constituting roughly 80-90% of cases), and the calcitonin-producing parafollicular C cells (medullary carcinoma, roughly 10%). The suspected diagnosis is clarified with the aid of ultrasonography, scintigraphy and fine-needle aspiration cytology. Primarily, carcinomas of the thyroid are treated surgically; in the case of differentiated carcinomas, surgery is followed by radio-iodine treatment, and in the follow-up period 131I scintigraphy is performed. During this period, physical examination, ultrasonography of the neck, monitoring of the tumours markers, and treatment with levothyroxine are applied (TSH-suppressive in cases of differentiated carcinoma). In the event of a recurrence showing rapid progression, when surgical and nuclear medical treatment modalities have been exhausted, chemotherapy can be given.