Differentiated thyroid carcinomas - epidemiology, etiopathogenesis, diagnostics and therapy

Abstract

© 2014, Serbian Medical Society. All rights reserved. Differentiated thyroid carcinomas (DTCs) present more than 90% of all thyroid tumours and include papillary and follicular carcinomas. Females suffer 2-3 times more often than men. Radiation is considered to be one of the most important etiological factors for the appearance of differentiated thyroid carcinomas, especially papillary carcinomas. DTCs may have a hereditary character in about 3% of cases. Disease usually presents in the form of slow growing thyroid nodules. The diagnostics is based on clinical examination, completed with ultrasonography and fine needle aspiration biopsy with cytological findings. DTCs patients require multidisciplinary therapeutic approach including total or near-total thyreoidectomy with postoperative application of radioactive iodine 131 for ablation of residual tumor as well as normal thyroid tissue. After that, the administration of L-thyroxine is required, at dose which inhibits the secretion of TSH. All patients require continuous monitoring, which also includes the determination of serum concentration of thyroglobulin. The prognosis is generally good, and the ten-year survival rate is over 90%. Recurrence is present in 10-15% of all patients, mainly in the neck, lymph nodes or thyroid region.