Thyroid Carcinoma: From Histopathology To Prognosis

Abstract

Thyroid carcinomas are fairly uncommon and include disease types that range from indolent localized papillary carcinomas to the fulminant anaplastic carcinomas. Surgical resection is the cornerstone of primary treatment for most thyroid carcinomas, and is often followed by adjuvant radioactive iodine treatment for both papillary and follicular types of cancer. Thyroid hormone replacement therapy is used for two main reasons: to rectify postsurgical hypothyroidism, and to prevent disease recurrence in patients with papillary or follicular carcinomas. Treatment for progressive metastatic disease is often of limited benefit. In families with inherited thyroid cancer syndromes, early diagnosis and intervention based on genetic testing might prevent poor prognosis. Multimodality treatments are widely recommended, although there is little evidence from prospective trials to support this approach. Care should be carefully coordinated by members of an experienced multidisciplinary team, and patients should be provided with education about diagnosis, prognosis, and treatment options to allow them to make informed contributions to decisions about their care.