Thyroid Cancer Surgery

  • Brian R. Untch
  • Dipti Kamani
  • Gregory W. RandolphEmail author


Surgery remains the most important treatment modality for most types of thyroid cancer. Thyroid cancers have a remarkable spectrum of clinical behavior; well-differentiated subtypes have excellent 10-year survival rates after surgery in contrast to anaplastic thyroid cancer, which is highly lethal even with aggressive treatment. The extent of thyroidectomy and lymph node dissection should be guided by cancer subtype, preoperative workup including imaging, and disease extent. Thyroidectomy should be carried out in a stepwise fashion with the goal of removing the gland and the cancer while limiting the risk of injury to the recurrent laryngeal nerve (RLN) and parathyroid glands. The surgeon should be vigilant in identifying RLN anatomy variability, and using intraoperative nerve monitor (IONM) can be a helpful adjunct to the surgeon, particularly in complex dissections. Critical to postoperative management is the recognition and treatment of complications from thyroidectomy and lymph node dissection. Surgery for recurrent thyroid cancer can be challenging, but good surgical and oncologic outcomes can be achieved with optimal surgical planning.


Thyroid cancer Papillary thyroid carcinoma Follicular thyroid carcinoma Hurthle cell carcinoma Anaplastic thyroid carcinoma Poorly differentiated thyroid carcinoma Microcarcinoma Laryngoscopy Thyroidectomy Neck dissection Recurrent laryngeal nerve Intraoperative neuromonitoring (IONM) 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Brian R. Untch
    • 1
  • Dipti Kamani
    • 2
  • Gregory W. Randolph
    • 2
    • 3
    Email author
  1. 1.Department of OtolaryngologyIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology—Head and Neck SurgeryMassachusetts Eye and Ear Infirmary, Harvard Medical SchoolBostonUSA
  3. 3.Department of SurgeryEndocrine Surgery Service, Massachusetts General Hospital, Harvard Medical SchoolBostonUSA

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