01 December 2005
Current management of differentiated thyroid carcinoma.
Gelsy Lupoli, Francesco Fonderico, Sara Colarusso, Annalisa Panico, Annalisa Cavallo, Lucia Di Micco, Angela Paglione, Luisa Costa, Giovanni LupoliMed Sci Monit 2005; 11(12): RA368-373 :: ID: 438949
Abstract
Papillary and follicular thyroid cancers, together termed differentiatedthyroid cancers (DTC), comprise the majority of thyroid carcinomas and have an optimal prognosis. MostDTCs appear as asymptomatic thyroid nodules. Fine-needle aspiration (FNA) cytology is the first diagnostictest for a thyroid nodule in a euthyroid patient. Surgery is the primary treatment for thyroid cancers.Most clinicians recommend near-total or total thyroidectomy, and then [sup]131[/sup]I ablation therapy, sinceits consequences are minimal and follow-up is facilitated. A total body scan (TBS) is performed 4 to7 days after [sup]131[/sup] I treatment. At a later stage, all patients should be treated with L-tiroxine so asto suppress TSH, and must undergo a periodic evaluation of TSH and thyroglobulin (Tg), the most sensitiveand specific marker of DTC. After 6-12 months, TBS with [sup]131[/sup]I is performed, a technique complementaryto serum Tg evaluation. For this technique, it is also necessary to have a high serum TSH concentration,obtained by withdrawing thyroxine therapy for 4 to 6 weeks. This standard method induces hypothyroidism.An alternative method to the withdrawal of thyroid hormones in the follow-up of DTC patients is to administerrecombinant human TSH (rh-TSH). After the dose of rhTSH, [sup]131[/sup]I is administered, and then TBS can beperformed 48-72 hours later. Currently, several authors have explored the possibility that rh-TSH-stimulatedTg levels may represent the only necessary test to differentiate patients with persistent disease fromdisease-free patients, without performing a diagnostic TBS.
Keywords: Carcinoma - therapy, Risk Factors, Thyroid Neoplasms - therapy
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
18 Mar 2024 : Clinical Research
Sexual Dysfunction in Women After Tibial Fracture: A Retrospective Comparative StudyMed Sci Monit In Press; DOI: 10.12659/MSM.944136
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
Most Viewed Current Articles
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952