[From limited to extensive radical operation in thyroid carcinoma]

The incidence of malignant thyroid tumors in Germany is about 1-2 cases per 100,000 inhabitants and year with a preponderance of female to male 3:1. Thus malignant thyroid tumors are rare and account for about 0.5% to 1% of all malignancies. Special consideration, however, has to be paid to the fact, that thyroid lesions associated with the risk of malignancy are much more frequent. Therefore identification of patients with particular risk for thyroid malignancy out of the 15% to 20% of the German population with thyroid lesions has to be the main scope. Prognosis of differentiated thyroid carcinomas is excellent and requires operative procedures adapted to histological tumor type and tumor stage. Hemithyroidectomy for small papillary tumors can be as adequate as total thyroidectomy including bilateral neck dissection plus mediastinal lymph node dissection in medullary thyroid carcinoma. Generally radical resection of tumor is the aim. Palliative modalities in distant metastatic disease or undifferentiated tumors are indicated to optimize additive or adjuvant therapy resp. to improve prognosis.