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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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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...
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Synthesis and Regulation of Thyroid Hormones01:20

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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...
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Related Experiment Video

Updated: Jan 12, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Active surveillance for small papillary thyroid carcinoma.

Yasuhiro Ito, Akira Miyauchi, Makoto Fujishima

    Endocrine-Related Cancer
    |November 6, 2025
    PubMed
    Summary

    Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) is a safe and effective initial management strategy. Patients on AS experience favorable outcomes, including no cancer-related deaths and better quality of life compared to immediate surgery.

    Keywords:
    active surveillancepapillary thyroid microcarcinomaprognosissurgery

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    Area of Science:

    • Oncology
    • Endocrinology
    • Surgical Oncology

    Background:

    • Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) has been practiced since the mid-1990s.
    • Numerous international studies support favorable outcomes for AS in PTMC management.
    • PTMC is defined as T1aN0M0, with low-risk characteristics.

    Purpose of the Study:

    • To evaluate the efficacy and safety of active surveillance (AS) as an initial management strategy for low-risk papillary thyroid microcarcinoma (PTMC).
    • To compare outcomes of AS with immediate surgery (IS) for PTMC, including prognosis, adverse events, and quality of life (QOL).

    Main Methods:

    • Review of studies reporting outcomes of AS for PTMC initiated in Japan and other countries.
    • Comparison of prognostic data, complication rates, and QOL metrics between AS and IS groups.
    • Analysis of conversion surgery (CS) outcomes in patients initially managed with AS.

    Main Results:

    • No thyroid carcinoma-related deaths reported in patients managed with AS.
    • AS shows comparable prognosis to immediate surgery (IS) for PTMC.
    • Patients on AS report better physical quality of life (QOL) and a lower overall incidence of unfavorable events compared to IS.

    Conclusions:

    • Active surveillance (AS) is an excellent initial management strategy for patients with low-risk papillary thyroid microcarcinoma (PTMC).
    • AS offers comparable oncological outcomes to immediate surgery while improving quality of life and reducing adverse events.
    • Conversion surgery for patients on AS does not significantly impact prognosis or increase unfavorable events.