Medical Therapy for Differentiated Thyroid Carcinoma*

DIFFERENTIATED thyroid carcinoma (papillary and follicular) is usually an indolent cancer, but it may be aggressive, especially in patients more than 50 yr old. In those with more aggressive rumors, effective therapy may reduce morbidity and mortality. By carefully considering each case, the outcome of treatment can be improved and the costs reduced. Thyroid carcinoma is treated by teams comprised of endocrinologists, surgeons, nuclear medicine specialists, and internists. It is important for physicians treating such patients to become familiar with the current therapy of differentiated thyroid carcinoma. In this review, we discuss nonsurgical therapy of patients with differentiated thyroid carcinoma. Surgical excision is usually the primary treatment for differentiated thyroid carcinoma, but the type and extent of surgery is controversial and the topic of many papers (for review, see Ref. 1). In general, near total or total thyroidectomy is recommended for all malignant lesions larger than 2 cm. In some instances of surgery for the diagnosis of follicular neoplasm based on needle aspiration biopsy, the diagnosis of follicular carcinoma is established after lobectomy.