Abstract
The careful selection of patients with nodular goiter for probable malignancy increases the likelihood of finding thyroid cancer at operation. All other patients with thyroid nodules must be carefully followed up and evaluated frequently to determine the possible need for operation. The thyroid lobe (or isthmus) containing a suspected lesion should be removed for microscopic pathologic examination, which is the only certain way to diagnose cancer of the thyroid. In most operable cases of cancer of the thyroid gland, thyroidectomy is completed because cancer cells are frequently found in the contralateral lobes; however, unilateral lobectomy is sufficient treatment for localized malignant adenoma. Appropriate neck dissections are indicated if cervical nodes are hard and enlarged or otherwise strongly suspected of containing metastases. In selected cases in which thyroid cancer is known or believed to have extended substernally beyond the possibility of removal by cervical incision, mediastinal dissection may be performed.
Published Version
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