Reference Work Entry

General Surgery

pp 1643-1650

Papillary Thyroid Cancer

  • Takashi UrunoAffiliated withDepartment of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of MedicineDepartment of Surgery, University of California San Francisco and UCSF/Mt. Zion Medical Center
  • , Orlo H. ClarkAffiliated withDepartment of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of MedicineDepartment of Surgery, University of California San Francisco and UCSF/Mt. Zion Medical Center

Pearls and Pitfalls

  • Papillary thyroid cancer (PTC) accounts for 80% of all thyroid cancers and is the most rapidly increasing cancer in women in the United States.

  • Latent thyroid cancer is present in 6.2–36% of thyroid glands at autopsy.

  • Neck ultrasound evaluates the thyroid gland for suspicious nodules, as well as for thyroid cancer metastasis in cervical lymph nodes.

  • Fine needle aspiration biopsy cytology (FNAC) under ultrasound guidance accurately diagnoses papillary, medullary, and anaplastic thyroid cancer and/or lymph node involvement.

  • A total or near-total thyroidectomy is indicated for most patients with clinical thyroid cancer greater than 1 cm in size.

  • Central neck and/or lateral neck dissection is indicated for clinically or scan-positive abnormal lymph nodes.

  • A nonoperative approach is being done in Japan for patients with isolated micro PTC (≤1 cm) by FNAC without nodal involvement, in whom the tumor is not adjacent to the recurrent laryngeal nerve or trachea.

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