Category: Thyroid

After definitive therapy for thyroid cancer, patients are followed by an endocrinologist or surgeon  or, less commonly, an oncologist. Exactly how the patient is followed and when they are seen depends on the individual physician and the perceived risk of recurrence. Generally, patients are seen every 3-6 months for 2-3 years then yearly . A …Read More »

Local recurrence of thyroid cancer generally means that the cancer has become clinically apparent in the immediate area were the thyroid gland was located. The actual space the thyroid occupies is known as the thyroid bed. For discussion purposes, the neck is divided into 7 zones. The diagram above demonstrates these. The thyroid bed is …Read More »

This is a photograph of a patient who is about 10 days post-op following surgery for local recurrence of papillary thyroid cancer. She had a near total thyroidectomy for thyroid cancer about 2 years before in another state. She had an elevated thyroglobulin level and an ultrasound reveal malignant tissue in her right thyroid bed. …Read More »

Regional recurrence of thyroid cancer means the cancer has spread to the regional lymph nodes in the neck. The drawing shows the surgical regions of the neck. As we’ve discussed on previous pages, recurrence in level 6 is considered local recurrence. Regional recurrence occurs in level 2 through 5. Disease in level 1 is very …Read More »

This is a photograph of a patient who is about 10 days post-op following a left modified radical neck dissection for regionally recurrent thyroid cancer. In this case the patient also had recurrence in the left thyroid bed. The previous thyroidectomy incision was incorporated into a longer oblique incision extending toward the left ear. The …Read More »

Modified radical neck dissection (MND) is a complicated operation. The risk of a life threatening complication is negligible, but there are risk to the procedure. We’ll review the major issues. Overall the risk a of self-limiting complication such as wound infection, seroma formation, limited shoulder motion or temporary nerve dysfunction is about 10%. The risk …Read More »

Distant recurrence is traditionally thought of as metastatic disease. When well-differentiated thyroid cancer metastasizes to distant organs, it most commonly spreads to the lungs, bone or brain. Un-expectantly, metastatic disease may not be a significant source of symptoms and may be indolent and clinically inapparent for years. This is especially true of small metastatic implants …Read More »

Incidental thyroid cancer is a term applied to very small, unsuspected papillary cancer identifiedincidentally on pathologic examination of thyroid tissue removed for benign disease. Incidental thyroid cancer is also known as micro papillary thyroid cancer. Depending on the source, micro papillary cancer may be broadly defined as papillary cancer of the thyroid <5 mm in …Read More »

Hashimoto’s Thyroiditis (HT) is a chronic inflammatory condition of the thyroid gland. It is a common cause of goiter and probably the most common cause of hypothyroidism in the United States. We will discuss it on our Website because of its relative common occurrence and because on occasion it may be a surgically important disease. …Read More »

Grave’s disease (GD)  is not typically considered a surgical problem in the United States. It is most commonly treated with radioactive iodine.  We will discuss it on our website because it may be treated surgically in certain situations. The photograph above shows a typical example of a thyroid gland affected by Grave’s disease. The gland …Read More »