Definition der R1-Resektion bei Schilddrüsenkarzinomen

[Hemithyroidectomy or total thyroidectomy for low-risk papillary thyroid cancer? : Surgical criteria for primary and secondary choice of treatment in an interdisciplinary treatment concept]

The increase in small intrathyroid papillary thyroid cancer (PTC) observed worldwide over the past two decades, with no increase in cancer-specific mortality, has challenged the previous concept of total thyroidectomy as a one-size-fits-all panacea. After exclusion of papillary microcarcinomas, a systematic review of 20 clinical studies published since 2002, which compared hemithyroidectomy (HT) to total thyroidectomy (TT), found comparable long-term oncological outcomes for low-risk papillary thyroid cancer (LRPTC) 1-4 cm in diameter, whereas postoperative complication rates were markedly lower for HT. To refine individual treatment plans, HT should be combined with ipsilateral central lymph node dissection and intraoperative frozen section analysis for staging. Based on recent evidence from studies and in consideration of individual risk factors, patients with LRPTC can be offered the concept of HT as an alternative to the standard TT. A prerequisite for the treatment selection and decision is a comprehensive patient clarification of the possible advantages and disadvantages of both approaches.

Malignant teratoma of the thyroid

Malignant thyroid teratoma in adults is a rare tumour with less than 40 cases reported worldwide. Our case is of a 29-year-old man who presented with a thyroid lump and compressive symptoms. He underwent multiple investigations before being diagnosed with a malignant thyroid teratoma. There are no established guidelines in the management of this tumour yet. In this case report, we discuss the diagnosis, treatment and follow-up of the patient and reflect on the published literature on this tumour.

Proposal for an extended pTNM classification of thyroid carcinoma : Commentary on deficits of the 8th edition of the TNM classification

In the 8th edition of the TNM classification of thyroid carcinomas, which was introduced in 2017, carcinomas with minimal extrathyroidal extension are no longer mentioned, which might cause problems. These tumors were explicitly categorized in previous TNM classifications (5-7th editions). Studies on the prognostic relevance of minimal extrathyroidal extension have shown conflicting results. Moreover, the vast majority of these studies retrospectively analyzed only subgroups of thyroid carcinomas (e.g. differentiated thyroid carcinoma, papillary thyroid carcinoma). The proposed subcategorization of the current TNM classification (8th edition) ensures the continuity of the parameter minimal extrathyroidal extension within the TNM categorization of thyroid carcinomas and also offers the possibility to prospectively analyze in a standardized manner the potential biological relevance of minimal extrathyroidal extension in relation to tumor categories (T/pT category).

[Proposal for an extended pTNM classification of thyroid carcinoma : Commentary on deficits of the 8th edition of the TNM classification (German version)]

In the 8th edition of the TNM classification of thyroid carcinomas, which was introduced in 2017, carcinomas with minimal extrathyroidal extension are no longer mentioned, which might cause problems. These tumors were explicitly categorized in previous TNM classifications (5-7th editions). Studies on the prognostic relevance of minimal extrathyroidal extension have shown conflicting results. Moreover, the vast majority of these studies retrospectively analyzed only subgroups of thyroid carcinomas (e.g. differentiated thyroid carcinoma, papillary thyroid carcinoma). The proposed subcategorization of the current TNM classification (8th edition) ensures the continuity of the parameter minimal extrathyroidal extension within the TNM categorization of thyroid carcinomas and also offers the possibility to prospectively analyze in a standardized manner the potential biological relevance of minimal extrathyroidal extension in relation to tumor categories (T/pT category).