Thyroid Cancer

Leonard Wartofsky, MD, MACP Department of Medicine Washington Hospital Center Washington, DC, USA   Douglas Van Nostrand, MD, FACP, FACNM Nuclear Medicine Washington Hospital Center Washington, DC, USA

PART I. General Considerations I: THYROID CANCER.- 1 Anatomy and Physiology of the thyroid gland: Clinical Correlates to Thyroid Cancer.- 2 Epidemiology of Thyroid Cancer.- 3 Molecular Pathogenesis of Thyroid Cancer & Oncogenes in Thyroid Cancer.- 4 Molecular Aspects of Thyroid Cancer in Children.- 5 The Role of Genetics in the Development of Familial Non-Medullary Thyroid Cancer.- 6 Apoptosis in Thyroid Cancer.- 7 Radiation-Induced Thyroid Cancer.- 8 Classification of Thyroid Malignancies.- 9 Staging of Thyroid Cancer.- 10 Recombinant human Thyrotropin (Thyrogen®).- PART II. GENERAL CONSIDERATIONS II: NUCLEAR MEDICINE.- 11 Radioiodine Whole Body Imaging.- 12 Primer and Atlas for the Interpretation of Radioiodine Whole-Body Scintigraphy.- 13 False-Positive Radioiodine-131 scans in Thyroid Cancer.- 14 The Utility of SPECT-CT in Differentiated Thyroid Cancer.- 15 Radioiodine scintigraphy with SPECT/CT: an important diagnostic tool for staging and risk stratification.- 16 Stunning by 131I scanning: Untoward Effect of 131I Thyroid Imaging Prior to Radioablation Therapy.- 17 Stunning is Not a Problem.- 18 Stunning: Does it Exist? A Commentary.- 19 To Perform or Not to Perform Radioiodine Scans Prior to 131I Remnant Ablation?.- PART III. THE THYROID NODULE.- 20 The Thyroid Nodule: Evaluation, Risk of Malignancy, and Management.- 21 Fine-Needle Aspiration.- 22 Diagnostic and Prognostic Molecular Markers in Thyroid Cancer.- 23 Ultrasonic Imaging of the Thyroid Gland.- 24 Radionuclide Imaging of Thyroid Nodules.- 25 18F Fluoro-deoxyglucose PET and Thyroid Nodules.- 26 Thyroid Nodules and Cancer Risk: Surgical Management.- 27 Thyroid Nodules in Children and Cancer Risk.- 28 Management of the Thyroid Nodule: A Comparison Of Published International Guidelines.- PART IV. WELL-DIFFERENTIATED THYROID CANCER A: PAPILLARY CARCINOMA: PRESENTATION.- 29 Papillary Carcinoma: Clinical Aspects.- 30 Papillary Microcarcinoma.- 31 Surgical Approach to Papillary Thyroid Cancer.- 32 Papillary Carcinoma: Cytology and Pathology.- B. INITIAL MANAGEMENT.- 33 Remnant Ablation, Adjuvant Treatment and Treatment of Locoregional Metastases with 131I.- 34 Thyroid Remnant Radioiodine Ablation with Recombinant Human Thyrotropin.- C. SURVEILLANCE.- 35 Follow-up Strategy in Papillary Thyroid Cancer.- 36 Thyroid Hormone Therapy and Thyrotropin Suppression.- 37 Thyroglobulin for Differentiated Thyroid Cancer: Measurement and Interferences.- 38 Thyroglobulin Antibodies and Their Measurement.- 39 Diagnosis of Recurrent Thyroid Cancer in Patients with Anti-Thyroglobulin Antibodies.- 40 Ultrasound of the neck lymph nodes.- 41 Surveillance Radioiodine Whole Body Scans.- 42 Radionuclide Imaging and Treatment of Children with Thyroid Cancer.- 43 Positron Emission Tomography-/Computed Tomography (PET-CT and PET) in Well-Differentiated Thyroid Cancer.- 44 Alternative Thyroid Imaging.- 45 MR and CT Imaging of Thyroid Cancer.- 46 Thyroglobulin in Lymph Node Aspirate.- 47 Management of the Patientswith Negative Radioiodine Scan and Elevated Serum Thyroglobulin.- 48 Prognosis in Papillary Thyroid Cancer.- 49 Surgical Management of Lymph Node Metastases.- 50 Utility of Second Surgery for Lymph Node Metastases.- 51 Papillary Cancer Special Aspects in Children.- 52 Special Presentations of Thyroid Cancer in Thyrotoxicosis, Renal Failure, and Struma Ovarii.- 53 Thyroglossal Duct Carcinoma.- 54 Thyroid Cancer in Pregnancy.- D. TREATMENT.- 55 Radiation and Radioactivity.- 56 131I Treatment of Distant Metastases.- 57 Treatment of Metastatic Thyroid Cancer with Radioiodine following preparation by Recombinant Human Thyrotopin.- 58 Dosimetrically-Determined Prescribed Activity of 131I for the Treatment of Metastatic Differentiated Thyroid Carcinoma.- 59 Simplified Methods of Dosimetry.- 60 Radioiodine Dosimetry with Recombinant human Thyrotropin.- 61 The Use of Lithium as an Adjuvant to Radioiodine In the Treatment of Thyroid Cancer.- 62 Side Effects of 131I for Therapy of DifferentiatedThyroid Carcinoma.- 63 Radiation Therapy in Papillary Carcinoma.- 64 Chemotherapy of Thyroid Cancer: General Principles.- 65 Bone Metastases from Differentiated Thyroid Carcinoma.- 66 A Summary of Rare Sites of Metastasis Secondary to Differentiated Thyroid Cancer.- 67 Adjunctive Local Approaches to Thyroid Nodules and Metastatic Thyroid Cancer.- 68 Radioiodine-Refractory Thyroid Cancer: Restoring Response to Radioiodine Therapy.- 69 Alternative and Complementary Treatment of Thyroid Disorders.- PART V. WELL-DIFFERENTIATED THYROID CANCER  FOLLICULAR CARCINOMA.- 70 Follicular Thyroid Carcinoma.- 71 Surgical Management of Follicular Cancer.- 72 Pathology of Follicular Cancer.- 73 Hürthle Cell Carcinoma.- 74 Follow-Up Strategy in Follicular Thyroid Cancer.- 75 Radionuclide Imaging and 131I Therapy in Follicular Thyroid Carcinoma.- 76 PET/CT in Follicular Cancer Including Hürthle Cell Cancer.- 77 Follicular Thyroid Cancer: Special Aspects in Children and Adolescents.- 78 External Radiation Therapy of Follicular Carcinoma.- 79 Determinants of Prognosis of Follicular Thyroid Carcinoma.- PART VI. VARIANTS OF THYROID CANCER.- 80 Aggressive Variants of Papillary Thyroid Carcinoma and Poorly Differentiated Carcinoma.- 81 Miscellaneous and Unusual Tumors of the Thyroid Gland.- 82 Pathology of Miscellaneous and Unusual Tumors of the Thyroid Gland.- PART VII. UNDIFFERENTIATED TUMORS: MEDULLARY THYROID CARCINOMA.- 83 Clinical Aspects of Medullary Thyroid Carcinoma.- 84 Cytology and Pathology of Medullary Carcinoma.- 85 Medullary Carcinoma of the Thyroid: Surgical Management.- 86 Radionuclide Imaging of Medullary Carcinoma.- 87 PET/CT in Medullary Thyroid Cancer.- 88 Radiation Therapy in Medullary Cancer.- 89 Medullary Carcinoma of the Thyroid: Chemotherapy.- 90 A Comparison of the ATA, NCCN, ETA, and BTA Guidelines for the Management of Medullary Thyroid Cancer.- PART VIII. UNDIFFERENTIATED TUMORS:  THYROID LYMPHOMA.- 91 Thyroid Lymphoma.- 92 Pathology of Lymphoma of the Thyroid.- 93 PET/CT in Lymphoma and Lymphoma of the Thyroid.- PART IX. UNDIFFERENTIATED TUMORS: ANAPLASTIC THYROID CANCER.- 94 Anaplastic Thyroid Carcinoma:  Clinical Aspects.- 95 Surgical Management of Anaplastic Thyroid Carcinoma.- 96  Pathology of Anaplastic Carcinoma.- 97 PET/CT in Anaplastic Cancer of the Thyroid.- 98 Anaplastic Thyroid Cancer.- 99 Chemotherapy for Anaplastic Thyroid Cancer.- 100 Anaplastic Thyroid Carcinoma:  Prognosis.- PART X. NEW FRONTIERS AND FUTURE DIRECTIONS.- 101 Advances in Radiation Therapy.- 102 New Approaches in Nuclear Medicine for Thyroid Cancer.- 103 124I in Differentiated Thyroid Cancer.- 104 Future Directions for Advanced Thyroid Cancer Therapy.- 105 Potential Approaches to Chemotherapy of Thyroid Cancer in the Future.- PART XI. Additional Resources.- 106 Prophylaxis against Radiation Exposure from Radioiodine.- 107 Low Iodine Diets.- 108 Appendix A: Books and Manuals.- 109 Appendix B: Additional Sources of Information: Support groups, Websites and additional information.- 110 Appendix C:   Forms and Instructions for Patients Treated with Radioactivity.