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Feature Article

Papillary thyroid cancer: the most common endocrine malignancy

James C Lee, Stanley B Sidhu

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Abstract

Papillary thyroid cancer has an excellent prognosis and over 90% of affected patients achieve long-term survival. Treatment is primarily by surgery and postoperative radioactive iodine ablation, which may be required to be repeated in cases of recurrence.

Key Points

  • The main risk factors for papillary thyroid cancer are childhood radiation exposure and a family history.
  • A thorough history and examination, followed by appropriate investigations, are required when a patient presents with a neck lump suspected to be thyroid cancer.
  • The initial treatment of papillary thyroid cancer consists of surgery with or without postoperative radioactive iodine ablation.
  • During follow up, disease-free status is defined by: no clinical evidence of tumour; no evidence of tumour on imaging; and an undetectable serum thyroglobulin level.
  • As different specialists are involved at different stages of the management of thyroid cancer, the involvement of the GP from the initial diagnosis to the long-term follow up of the patient may provide a point of contact for the patient, a source of forgotten information, and a sense of continuity of care.

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