Advances in the diagnosis and management of thyroid neoplasms

Thyroid cancers are still the most common endocrine cancers. They are domin ated by well-differentiated carcinomas, including papillary carcinoma, foll icular carcinoma, and medullary thyroid carcinoma. Diagnosis is based on fi ne-needle aspiration cytologic examination. Recently, reverse transcription polymerase chain reaction for the detection of cancer-specific mRNA was sh own to be a useful adjunct in both initial diagnosis and detection of recur rent disease, In addition, positron emission tomography has become a valuab le tool for staging and surveillance of thyroid cancer. Given the gradual p erfection of surgical technique and reduction in complication rates, near-t otal and total thyroidectomy should be offered to patients with well-differ entiated carcinoma. For medullary thyroid carcinoma, near-total and total t hyroidectomy with routine central and bilateral functional neck dissection are recommended. So far, no effective treatment exists for anaplastic thyro id carcinoma. (C) 2000 Lippincott Williams & Wilkins, Inc.