Management of Thyroid and Parathyroid Cancers

Abstract

Thyroid and parathyroid cancers are both relatively rare malignancies, although the incidence of thyroid cancer is increasing at a rate of 3% per year. The mainstay of treatment of these endocrine malignancies has been surgical resection and radioactive iodine treatment for thyroid cancer. Differentiated thyroid cancers (DTCs) encompass papillary and follicular carcinomas and are responsive to radioactive iodine treatment and thyroid stimulating hormone suppression, in contrast to medullary thyroid cancer (MTC). There is now a greater understanding of the molecular pathogenesis of DTCs, poorly differentiated and anaplastic thyroid cancers, and MTC. This has prompted numerous phase studies utilizing oral biologically targeted agents that inhibit a variety of tyrosine kinase inhibitors, such as the vascular endothelial growth factor receptors, c-kit, ret, and platelet-derived growth factor receptor. This review discusses the epidemiology, histologies, pathogenesis, and issues in the management of thyroid and parathyroid cancers.