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The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...

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Updated: Jun 13, 2026

Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

Published on: June 9, 2023

Papillary thyroid carcinoma: debate at rest.

A A Sonkar¹, S Rajamanickam, D Singh

¹Department of Surgery, Chhatrapathi Shahuji Medical University, Lucknow, UP, India.

Indian Journal of Cancer

|May 8, 2010

Summary

Total thyroidectomy is recommended for papillary thyroid cancer (PTC) nodules over 1.5 cm. While lymph node metastases increase recurrence, dissection may be beneficial, with low complication risks in expert hands.

Area of Science:

Oncology
Endocrinology
Surgical Oncology

Background:

Papillary thyroid cancer (PTC) is the most prevalent well-differentiated thyroid cancer.
PTC incidence is rising, potentially due to increased high-resolution ultrasound (HRUSG) use.
Understanding optimal surgical management is crucial for patient outcomes.

Purpose of the Study:

To review current evidence and guidelines on papillary thyroid cancer management.
To clarify the extent of thyroidectomy and role of lymph node dissection in PTC.
To assess the risks associated with surgical interventions for PTC.

Main Methods:

Comprehensive literature search of MEDLINE and OVID databases.
Inclusion of recently published consensus guidelines.

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Systematic review of studies pertaining to papillary thyroid carcinoma.

Main Results:

Total thyroidectomy is the preferred surgical approach for PTC nodules exceeding 1.5 cm.
Lymph node metastases do not significantly impact overall survival but elevate recurrence rates.
Early lymph node dissection is recommended for ultrasonographically malignant nodes.

Conclusions:

The extent of thyroidectomy for PTC is largely settled, favoring total thyroidectomy for larger nodules.
Lymph node dissection can be beneficial for reducing recurrence risk in PTC.
Surgical complications like nerve injury and hypoparathyroidism are minimal in experienced surgeons' hands, even in redo procedures.