[Surgery of thyroid cancer].

Cancer of the thyroid is a rare malignant tumour in all parts of the world. The diagnosis is established by the clinical findings, thyroid scan, ultrasound, needle biopsy cytology. Solitary, solid tumours on ultrasound and scan have an increased risk of cancer, especially if these lesions show a further tendency to increase in size, despite sufficient suppressive treatment with thyroxine. In these cases the risk of cancer is more pronounced in nonendemic areas in men, in recurrent goitres, patients with a history of radiation of the neck during childhood, and with solitary lumps under 20 years and over 60 years of age. The surgical treatment includes lobectomy on the involved side and subtotal resection of the opposite lobe. Total thyroidectomy is generally used only for medullary carcinoma. In the future, a more selective surgical approach seems to be justified in thyroid cancer because of its varying malignancy. Close cooperation between the surgeon, the pathologist, the radiologist and the endocrinologist is essential in such circumstances. The prognosis of thyroid cancer is influenced by the histological type, the stage of the tumour, and the age of the patient. The prognosis is excellent in tumours limited to the thyroid gland and in those of papillary type or follicular type with little vascular invasion. Undifferentiated tumours always have a bad prognosis.