Which of the following would be the best treatment for a 2 cm thyroid nodule in a 50 year old man with FNAC revealing it to be a papillary carcinoma
Correct Answer: Near total thyroidectomy with central neck dissection
Description: For a patient with a unilateral thyroid malignancy and no evidence of metastatic disease, there are several rationales to consider total thyroidectomy, including facilitation of RAI ablation, which is much less effective and requires a larger dosage if residual thyroid exists the frequent presence of occult multifocal disease and facilitating the use of Tg as a tumor marker, which is most useful if there is no remaining normal thyroid. In the setting of clinically negative central compament nodes, a prophylactic level VI dissection dissection is more clearly indicated in higher risk situations (age greater than 45 is high risk) Source : Sabiston 20th edition Pg : 907
Category:
Surgery
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