Skip to main content
SpringerLink
Log in

Cancer of the Thyroid

  • Chapter
  • First Online:
Practical Medical Oncology Textbook

Part of the book series: UNIPA Springer Series ((USS))

  • 3320 Accesses

Abstract

Thyroid cancers are the most frequent endocrine neoplasms whose incidence is globally increasing. Thyroid carcinomas basically derived from follicular (papillary, follicular, anaplastic and poorly differentiated) or parafollicular cells (medullary). The diagnostic evaluation of thyroid cancers is mainly based on neck ultrasonography along with fine needle aspiration. First initial risk evaluation should be carried out postoperatively, while a dynamic risk stratification should be continually assessed to personalize treatment. Whereas combination of surgery, adjuvant radioactive iodine (RAI) ablation, and hormone therapy enables high rates of cure in differentiated tumors (DTC), surgical resection may represent the only definitive therapy in medullary (MTC) and poorly differentiated cancers. International regulatory agencies have recently approved targeted therapy for iodine refractory-DTC (sorafenib and lenvatinib) and for progressive or metastatic MTC (cabozantinib and vandetanib).

Authors Valerio Gristina, Nadia Barraco, and Silvio Buscemi should be considered equally co-first authors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Chen AY, Jemal A, Ward EM. Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005. Cancer. 2009;115(16):3801–7.

    Article  PubMed  Google Scholar 

  2. Newbold KL, Flux G, Wadsley J. Radioiodine for high risk and radioiodine refractory thyroid cancer: current concepts in management. Clin Oncol (R Coll Radiol). 2017;29(5):307–9.

    Article  CAS  PubMed  Google Scholar 

  3. Perren A, Schmid S, Locher T, et al. BRAF and endocrine tumors: mutations are frequent in papillary thyroid carcinomas, rare in endocrine tumors of the gastrointestinal tract and not detected in other endocrine tumors. Endocr Relat Cancer. 2004;11(4):855–60.

    Article  CAS  PubMed  Google Scholar 

  4. Davies L, Morris LG, Haymart M, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Disease State clinical review: the increasing incidence of thyroid cancer. Endocr Pract. 2015;21(6):686–96.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Vigneri R, Malandrino P, Vigneri P. The changing epidemiology of thyroid cancer: why is incidence increasing? Curr Opin Oncol. 2015;27(1):1–7.

    Article  PubMed  Google Scholar 

  6. Kabata P, Kaniuka-Jakubowska S, Kabata W, et al. Primary Ewing sarcoma of the thyroid-eight cases in a decade: a case report and literature review. Front Endocrinol (Lausanne). 2017;8:257.

    Article  PubMed  Google Scholar 

  7. Acquaviva G, Visani M, Repaci A, et al. Molecular pathology of thyroid tumours of follicular cells: a review of genetic alterations and their clinicopathological relevance. Histopathology. 2018;72(1):6–31.

    Article  PubMed  Google Scholar 

  8. Brennan MD, Bergstralh EJ, van Heerden JA, McConahey WM. Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin Proc. 1991;66(1):11–22.

    Article  CAS  PubMed  Google Scholar 

  9. Baloch ZW, LiVolsi VA. Special types of thyroid carcinoma. Histopathology. 2018;72(1):40–52.

    Article  PubMed  Google Scholar 

  10. Volante M, Collini P, Nikiforov YE, et al. Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. Am J Surg Pathol. 2007;31(8):1256–64.

    Article  PubMed  Google Scholar 

  11. Cosgrove D, Piscaglia F, Bamber J, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: clinical applications. Ultraschall Med. 2013;34(3):238–53.

    Article  CAS  PubMed  Google Scholar 

  12. Pacini F, Castagna MG, Brilli L, Pentheroudakis G, Group EGW. Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(Suppl 7):vii110–9.

    Article  PubMed  Google Scholar 

  13. Siadati S, Rabiee SM, Alijanpour E, Bayani MA, Nikbakhsh N. The diagnostic value of fine needle aspiration in comparison with frozen section in thyroid nodules: a 20-year study. Caspian J Intern Med. 2017;8(4):301–4.

    PubMed  PubMed Central  Google Scholar 

  14. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1):1–133.

    Article  PubMed Central  Google Scholar 

  15. Glikson E, Alon E, Bedrin L, Talmi YP. Prognostic factors in differentiated thyroid cancer revisited. Isr Med Assoc J. 2017;19(2):114–8.

    PubMed  Google Scholar 

  16. Krajewska J, Chmielik E, Jarząb B. Dynamic risk stratification in the follow-up of thyroid cancer: what is still to be discovered in 2017? Endocr Relat Cancer. 2017;24(11):R387–402.

    Article  CAS  PubMed  Google Scholar 

  17. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159–65.

    Article  PubMed  Google Scholar 

  18. Nikiforov YE, Steward DL, Robinson-Smith TM, et al. Molecular testing for mutations in improving the fine-needle aspiration diagnosis of thyroid nodules. J Clin Endocrinol Metab. 2009;94(6):2092–8.

    Article  CAS  PubMed  Google Scholar 

  19. Cantara S, Capezzone M, Marchisotta S, et al. Impact of proto-oncogene mutation detection in cytological specimens from thyroid nodules improves the diagnostic accuracy of cytology. J Clin Endocrinol Metab. 2010;95(3):1365–9.

    Article  CAS  PubMed  Google Scholar 

  20. Roth MY, Witt RL, Steward DL. Molecular testing for thyroid nodules: review and current state. Cancer. 2018;124(5):888–98.

    Article  PubMed  Google Scholar 

  21. Mahmoudian-Sani MR, Mehri-Ghahfarrokhi A, Asadi-Samani M, Mobini GR. Serum miRNAs as biomarkers for the diagnosis and prognosis of thyroid cancer: a comprehensive review of the literature. Eur Thyroid J. 2017;6(4):171–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Wendler J, Kroiss M, Gast K, et al. Clinical presentation, treatment and outcome of anaplastic thyroid carcinoma: results of a multicenter study in Germany. Eur J Endocrinol. 2016;175(6):521–9.

    Article  CAS  PubMed  Google Scholar 

  23. Bilimoria KY, Bentrem DJ, Ko CY, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg. 2007;246(3):375–381; discussion 381-374.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sawka AM, Thephamongkhol K, Brouwers M, Thabane L, Browman G, Gerstein HC. Clinical review 170: a systematic review and metaanalysis of the effectiveness of radioactive iodine remnant ablation for well-differentiated thyroid cancer. J Clin Endocrinol Metab. 2004;89(8):3668–76.

    Article  CAS  PubMed  Google Scholar 

  25. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.

    Article  PubMed  Google Scholar 

  26. Brose MS, Nutting CM, Jarzab B, et al. Sorafenib in radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer: a randomised, double-blind, phase 3 trial. Lancet. 2014;384(9940):319–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Schlumberger M, Tahara M, Wirth LJ, et al. Lenvatinib versus placebo in radioiodine-refractory thyroid cancer. N Engl J Med. 2015;372(7):621–30.

    Article  PubMed  Google Scholar 

  28. Dang RP, McFarland D, Le VH, et al. Neoadjuvant therapy in differentiated thyroid cancer. Int J Surg Oncol. 2016;2016:3743420.

    PubMed  PubMed Central  Google Scholar 

  29. Kovatch KJ, Hoban CW, Shuman AG. Thyroid cancer surgery guidelines in an era of de-escalation. Eur J Surg Oncol. 2017;44:297.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Miyauchi A. Clinical trials of active surveillance of papillary microcarcinoma of the thyroid. World J Surg. 2016;40(3):516–22.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mendelsohn AH, Elashoff DA, Abemayor E, St John MA. Surgery for papillary thyroid carcinoma: is lobectomy enough? Arch Otolaryngol Head Neck Surg. 2010;136(11):1055–61.

    Article  PubMed  Google Scholar 

  32. Barney BM, Hitchcock YJ, Sharma P, Shrieve DC, Tward JD. Overall and cause-specific survival for patients undergoing lobectomy, near-total, or total thyroidectomy for differentiated thyroid cancer. Head Neck. 2011;33(5):645–9.

    Article  PubMed  Google Scholar 

  33. Adam G, Cınar C, Akbal E. Rare thyroid cartilage involvement of multiple myeloma visualized on F-18 FDG-PET/CT imaging: 3 case reports. Indian J Surg Oncol. 2014;5(3):194–5.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Macedo FI, Mittal VK. Total thyroidectomy versus lobectomy as initial operation for small unilateral papillary thyroid carcinoma: a meta-analysis. Surg Oncol. 2015;24(2):117–22.

    Article  PubMed  Google Scholar 

  35. Sugitani I, Fujimoto Y, Yamada K, Yamamoto N. Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 2008;32(11):2494–502.

    Article  PubMed  Google Scholar 

  36. Ito Y, Miyauchi A. Is surgery necessary for papillary thyroid microcarcinomas? Nat Rev Endocrinol. 2011;8(1):9; author reply 9.

    PubMed  Google Scholar 

  37. Pilli T, Brianzoni E, Capoccetti F, et al. A comparison of 1850 (50 mCi) and 3700 MBq (100 mCi) 131-iodine administered doses for recombinant thyrotropin-stimulated postoperative thyroid remnant ablation in differentiated thyroid cancer. J Clin Endocrinol Metab. 2007;92(9):3542–6.

    Article  CAS  PubMed  Google Scholar 

  38. Chianelli M, Todino V, Graziano FM, et al. Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients. Eur J Endocrinol. 2009;160(3):431–6.

    Article  CAS  PubMed  Google Scholar 

  39. Andresen NS, Buatti JM, Tewfik HH, Pagedar NA, Anderson CM, Watkins JM. Radioiodine ablation following thyroidectomy for differentiated thyroid cancer: literature review of utility, dose, and toxicity. Eur Thyroid J. 2017;6(4):187–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Hovens GC, Stokkel MP, Kievit J, et al. Associations of serum thyrotropin concentrations with recurrence and death in differentiated thyroid cancer. J Clin Endocrinol Metab. 2007;92(7):2610–5.

    Article  CAS  PubMed  Google Scholar 

  41. Wells SA, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25(6):567–610.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ladenson PW, Braverman LE, Mazzaferri EL, et al. Comparison of administration of recombinant human thyrotropin with withdrawal of thyroid hormone for radioactive iodine scanning in patients with thyroid carcinoma. N Engl J Med. 1997;337(13):888–96.

    Article  CAS  PubMed  Google Scholar 

  43. Salavati A, Puranik A, Kulkarni HR, Budiawan H, Baum RP. Peptide receptor radionuclide therapy (PRRT) of medullary and nonmedullary thyroid cancer using radiolabeled somatostatin analogues. Semin Nucl Med. 2016;46(3):215–24.

    Article  PubMed  Google Scholar 

  44. Orlandi F, Caraci P, Berruti A, et al. Chemotherapy with dacarbazine and 5-fluorouracil in advanced medullary thyroid cancer. Ann Oncol. 1994;5(8):763–5.

    Article  CAS  PubMed  Google Scholar 

  45. Sherman SI. Cytotoxic chemotherapy for differentiated thyroid carcinoma. Clin Oncol (R Coll Radiol). 2010;22(6):464–8.

    Article  CAS  PubMed  Google Scholar 

  46. Tohyama O, Matsui J, Kodama K, et al. Antitumor activity of lenvatinib (e7080): an angiogenesis inhibitor that targets multiple receptor tyrosine kinases in preclinical human thyroid cancer models. J Thyroid Res. 2014;2014:638747.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Wells SA, Robinson BG, Gagel RF, et al. Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol. 2012;30(2):134–41.

    Article  CAS  PubMed  Google Scholar 

  48. Elisei R, Schlumberger MJ, Müller SP, et al. Cabozantinib in progressive medullary thyroid cancer. J Clin Oncol. 2013;31(29):3639–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Martinez FJ, Calverley PM, Goehring UM, Brose M, Fabbri LM, Rabe KF. Effect of roflumilast on exacerbations in patients with severe chronic obstructive pulmonary disease uncontrolled by combination therapy (REACT): a multicentre randomised controlled trial. Lancet. 2015;385(9971):857–66.

    Article  CAS  PubMed  Google Scholar 

  50. Ding T, Zhou F, Chen X, et al. Continuation of gefitinib plus chemotherapy prolongs progression-free survival in advanced non-small cell lung cancer patients who get acquired resistance to gefitinib without T790M mutations. J Thorac Dis. 2017;9(9):2923–34.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Arao T, Matsumoto K, Furuta K, et al. Acquired drug resistance to vascular endothelial growth factor receptor 2 tyrosine kinase inhibitor in human vascular endothelial cells. Anticancer Res. 2011;31(9):2787–96.

    CAS  PubMed  Google Scholar 

  52. Finke J, Ko J, Rini B, Rayman P, Ireland J, Cohen P. MDSC as a mechanism of tumor escape from sunitinib mediated anti-angiogenic therapy. Int Immunopharmacol. 2011;11(7):856–61.

    Article  CAS  PubMed  Google Scholar 

  53. Carlomagno F, Santoro M. Identification of RET kinase inhibitors as potential new treatment for sporadic and inherited thyroid cancer. J Chemother. 2004;16(Suppl 4):49–51.

    Article  CAS  PubMed  Google Scholar 

  54. Isham CR, Netzel BC, Bossou AR, et al. Development and characterization of a differentiated thyroid cancer cell line resistant to VEGFR-targeted kinase inhibitors. J Clin Endocrinol Metab. 2014;99(6):E936–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Jin N, Jiang T, Rosen DM, Nelkin BD, Ball DW. Dual inhibition of mitogen-activated protein kinase kinase and mammalian target of rapamycin in differentiated and anaplastic thyroid cancer. J Clin Endocrinol Metab. 2009;94(10):4107–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Liu D, Xing J, Trink B, Xing M. BRAF mutation-selective inhibition of thyroid cancer cells by the novel MEK inhibitor RDEA119 and genetic-potentiated synergism with the mTOR inhibitor temsirolimus. Int J Cancer. 2010;127(12):2965–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Smallridge RC, Copland JA, Brose MS, et al. Efatutazone, an oral PPAR-γ agonist, in combination with paclitaxel in anaplastic thyroid cancer: results of a multicenter phase 1 trial. J Clin Endocrinol Metab. 2013;98(6):2392–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Lin Z, Wu VW, Lin J, Feng H, Chen L. A longitudinal study on the radiation-induced thyroid gland changes after external beam radiotherapy of nasopharyngeal carcinoma. Thyroid. 2011;21(1):19–23.

    Article  PubMed  Google Scholar 

  59. Cohen EE, Tortorici M, Kim S, Ingrosso A, Pithavala YK, Bycott P. A phase II trial of axitinib in patients with various histologic subtypes of advanced thyroid cancer: long-term outcomes and pharmacokinetic/pharmacodynamic analyses. Cancer Chemother Pharmacol. 2014;74(6):1261–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Cohen EE, Rosen LS, Vokes EE, et al. Axitinib is an active treatment for all histologic subtypes of advanced thyroid cancer: results from a phase II study. J Clin Oncol. 2008;26(29):4708–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Ho AL, Grewal RK, Leboeuf R, et al. Selumetinib-enhanced radioiodine uptake in advanced thyroid cancer. N Engl J Med. 2013;368(7):623–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Rothenberg SM, Daniels GH, Wirth LJ. Redifferentiation of iodine-refractory BRAF V600E-mutant metastatic papillary thyroid cancer with Dabrafenib-response. Clin Cancer Res. 2015;21(24):5640–1.

    Article  PubMed  Google Scholar 

  63. Rosove MH, Peddi PF, Glaspy JA. BRAF V600E inhibition in anaplastic thyroid cancer. N Engl J Med. 2013;368(7):684–5.

    Article  CAS  PubMed  Google Scholar 

  64. Vaisman F, Rosado de Castro PH, Lopes FP, et al. Is there a role for peptide receptor radionuclide therapy in medullary thyroid cancer? Clin Nucl Med. 2015;40(2):123–7.

    Article  PubMed  Google Scholar 

  65. Brest P, Lassalle S, Hofman V, et al. MiR-129-5p is required for histone deacetylase inhibitor-induced cell death in thyroid cancer cells. Endocr Relat Cancer. 2011;18(6):711–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy

    Lorena Incorvaia

  2. Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Valerio Gristina

  3. Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Nadia Barraco

  4. Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Silvio Buscemi

  5. Clinical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and public Health, University of Brescia at ASST Spedali Civili di Brescia, Brescia, Italy

    Alfredo Berruti

Authors
  1. Valerio Gristina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nadia Barraco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Silvio Buscemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lorena Incorvaia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alfredo Berruti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lorena Incorvaia .

Editor information

Editors and Affiliations

  1. Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Antonio Russo

  2. Oncology Department, University of Antwerp, Edegem, Belgium

    Marc Peeters

  3. Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy

    Lorena Incorvaia

  4. Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai System & Icahn School of Medicine, Mount Sinai, NY, USA

    Christian Rolfo

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gristina, V., Barraco, N., Buscemi, S., Incorvaia, L., Berruti, A. (2021). Cancer of the Thyroid. In: Russo, A., Peeters, M., Incorvaia, L., Rolfo, C. (eds) Practical Medical Oncology Textbook. UNIPA Springer Series. Springer, Cham. https://doi.org/10.1007/978-3-030-56051-5_56

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-56051-5_56

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-56050-8

  • Online ISBN: 978-3-030-56051-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation