RECURRENCE OF PAPILLARY THYROID CANCER FOLLOWING INITIAL
PRIMARY TREATMENT; A NOT UNCOMMON PROBLEM
Papillary thyroid cancer (PTC) is the most common type
of thyroid cancer (TC), and accounts for about 80 – 85 % of follicular
cell-derived TCs in most western countries. Despite its relatively ‘benign’
biological behavior, recurrences are not uncommon, occurring in up to 20 - 30 %
of patients following primary treatment of PTC, usually within the first decade
after surgery. Most recurrences (80 %) will occur in the neck alone and involve
the cervical lymph nodes (in 75 % of cases), thyroid remnant (if present, 20 %)
or tracheal and local muscles (5 %). The remaining 20 % of patients with
disease recurrence develop distant metastatic disease, most commonly to the
lungs (in 60 % of patients). These data emphasize the importance of the initial
therapeutic management. A radical (and safe!) surgical operation should be
performed by an experienced endocrine surgeon. TSH-suppression therapy and
selective use of radioiodine ablation therapy -when indicated- are necessary to
optimize therapeutic results.
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