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Management of Low-risk Papillary Thyroid Cancer in a Patient with Familial Non-Medullary Thyroid Cancer

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Controversies in Thyroid Nodules and Differentiated Thyroid Cancer

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Abstract

The optimal surgical management of low-risk papillary thyroid cancer (PTC) has remained a controversial topic for many decades. Recent guidelines propose that both thyroid lobectomy and total thyroidectomy for low-risk PTC may be appropriate and safe, based on available clinical information and patient preferences. Approximately 7–10% of patients with PTC have a family history of thyroid cancer. Some investigators have suggested familial PTC is more aggressive, with advanced disease at presentation and a higher risk of recurrence. In this chapter, we discuss the options available for the surgical management of patients with low-risk PTC and a family history of differentiated thyroid cancer. While there is reportedly no difference in survival among patients with low-risk PTC treated with thyroid lobectomy versus total thyroidectomy, patients with familial PTC (three or more first-degree relatives affected) may benefit from total thyroidectomy, given the higher risk of multicentricity and bilateral tumors, and risk of recurrence. Alternatively, for patients diagnosed with low-risk PTC on screening, with only two first-degree relatives affected with differentiated thyroid cancer, a strong desire to avoid thyroid hormone replacement and commitment to participate in an active surveillance program, a thyroid lobectomy is a reasonable treatment approach.

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Authors and Affiliations

  1. Department of Surgery, Stanford University, Stanford, CA, USA

    Wilson Alobuia & Electron Kebebew

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  1. Wilson Alobuia
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  2. Electron Kebebew
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Correspondence to Electron Kebebew .

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Editors and Affiliations

  1. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Sanziana A. Roman

  2. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Wen T. Shen

  3. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Julie Ann Sosa

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Alobuia, W., Kebebew, E. (2023). Management of Low-risk Papillary Thyroid Cancer in a Patient with Familial Non-Medullary Thyroid Cancer. In: Roman, S.A., Shen, W.T., Sosa, J.A. (eds) Controversies in Thyroid Nodules and Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-031-37135-6_7

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  • DOI: https://doi.org/10.1007/978-3-031-37135-6_7

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