Prognosis and management of invasive well-differentiated thyroid cancer

Invasive thyroid cancer is often asymptomatic and can take the surgeon and the patient by surprise. Maintenance of a high level of suspicion in patients who present with symptoms, an abnormal examination, recurrent disease, or documented metastatic disease lead the clinician to obtain appropriate cross-sectional imaging that helps to define the full extent of the disease. Specific guidelines are provided for the management of the various structures in the neck that are at risk for involvement by disease extension outside the gland or extracapsular extension outside a lymph node with involvement by metastatic disease. This article reviews the prognosis, diagnosis, management, and implications of invasive thyroid cancer affecting the various structures of the central and lateral compartments of the neck.