Thyroid carcinoma

Diagnostic methods and treatment options for differentiated and medullary thyroid carcinoma are continuously influenced by new trends and techniques. Our review therefore displays the most recent clinical practices for diagnosis and operative treatment of differentiated and medullary thyroid carcinoma.

Among the new diagnostic methods, high-resolution ultrasonography plays an important role for both the evaluation of thyroid nodules and the detection of enlarged suspicious cervical lymph nodes. The results of ultrasound will definitely influence operative decisions. A second step to diagnose medullary thyroid carcinoma is calcitonin measurement before surgery, which is sensitive and specific enough to detect medullary thyroid carcinoma in patients with thyroid nodules. Surgical treatment for differentiated or medullary thyroid carcinoma mostly consists of total or near-total thyroidectomy. An additional central or lateral modified-radical neck dissection might help to reduce local recurrence, especially in medullary carcinoma, but still does not influence significantly the survival rates. Monitoring of the recurrent laryngeal nerve during surgery is used increasingly. According to the newest literature, however, compared with visual identification of the laryngeal nerve, it cannot be considered as superior.

Diagnosis and treatment of thyroid carcinoma are still subjected to changes and the different options of surgical treatment in particular will be continuously discussed in the future.