THERAPY OF INFLAMMATORY AND MALIGNANT DIS EASES OF THE THYROID-GLAND

Most cases of thyroiditis can be treated with antibiotics, antiphlogis tics, and corticosteroids. In case of abscess caused by bacterial infe ction or compression of the trachea surgical therapy is required for d rainage and resection. The prognosis for differentiated malignant tumo urs of the thyroid gland is good even if metastases have occurred. The recommended therapy includes total resection of the thyroid gland and radioiodine therapy to eliminate any remaining thyroid tissue. For an aplastic thyroid carcinomas surgery should be considered because of th e extremely poor prognosis for these types of tumours. Resection shoul d be performed to improve the patient's quality of life by avoiding tr acheostoma or to ensure normal nutritional uptake. Medullary thyroid c arcinoma is known in sporadic and in hereditary forms. Thyroidectomy i s the accepted therapy. In 15% of the patients we observed the syndrom e of multiple endocrine neoplasms (MEN), which is a form of thyroid ca rcinoma complicated by pheochromocytoma and hyperparathyroidism. Diagn osis of thyroid carcinomas includes examination of the patient, scinti graphy and ultrasonography of the thyroid gland, and cytological exami nation by aspiration biopsy. Post-operative care includes substitution of thyroid hormones, regular measurement of the thyreoglobuline level s in the blood, and examination for metastases in the lungs, the abdom en, and the bones.