Unraveling the Spectrum of Thyroid Carcinoma: From Aggressive Anaplastic to Curable Differentiated Forms - A Comprehensive Narrative Review

Thyroid carcinoma encompasses a spectrum of malignancies with distinct clinical characteristics, management strategies, and prognoses. This narrative review article provides an in-depth examination of anaplastic thyroid carcinoma (ATC), papillary thyroid carcinoma (PTC), Hurthle cell carcinoma (HCC), and medullary thyroid carcinoma (MTC), offering insights into their epidemiology, diagnostic and treatment modalities. Anaplastic thyroid carcinoma is a highly aggressive and undifferentiated form of thyroid cancer, often associated with poor prognosis. Treatment strategies include combined resection and radiotherapy, but late-stage cases exhibit limited therapeutic options, emphasizing the need for novel therapeutic approaches. Papillary thyroid carcinoma, the most common thyroid cancer, generally carries a favorable prognosis. The article discusses surgical interventions like total thyroidectomy and lobectomy, along with minimally invasive techniques such as transoral endoscopic thyroidectomy vestibular approach (TOETVA) and robotic thyroidectomy. The importance of considering health-related quality of life in the treatment decision-making process is highlighted. Hurthle cell carcinoma, a rare and aggressive subtype, is explored with a focus on factors influencing prognosis. Surgical management, including thyroid lobectomy, completion thyroidectomy, and iodine-۱۳۱ therapy, is discussed in detail. Medullary thyroid carcinoma is categorized into hereditary and sporadic forms, each requiring specific approaches. The review emphasizes the significance of genetic testing for patients at risk of multiple endocrine neoplasia syndrome (MEN۲) and the need for early thyroidectomy in genetic RET mutation carriers. Furthermore, the article evaluates the extent of surgery, the role of radioiodine therapy, and the significance of follow-up in treating differentiated thyroid carcinomas (DTC). Surgical approaches for follicular thyroid carcinoma (FTC) and factors influencing the decision for total thyroidectomy versus lobectomy are elaborated upon. In summary, this narrative review provides a comprehensive overview of thyroid carcinoma subtypes, their epidemiology, surgical interventions, and postoperative management, offering valuable insights for clinicians and researchers in the field.

کلیدواژه ها:

thyroid carcinoma ، Anaplastic Thyroid Carcinoma (ATC) ، Papillary Thyroid Carcinoma (PTC) ، Hurthle Cell Carcinoma (HCC) ، Medullary Thyroid Carcinoma (MTC) ، Epidemiology ، Treatment strategies ، genetic testing ، RET Mutation ، thyroidectomy