Das postoperativ zufällig entdeckte schilddrüsenkarzinom

The postoperative incidental finding of a thyroid cancer in for other pathology resected thyroid raises the question whether exception from surgical standards in thyroid cancer are allowed, justified, or recommended. Reduction of patient's stress and operative morbidity competes with oncologic radicality and optimal prognosis. Standard in thyroid cancer surgery means total thyroidectomy with central lymph node dissection and occasional extension with neck dissection. Prognostic scores of differentiated thyroid cancer detect a low-risk group of patients with encapsulated papillary cancer ≤1 cm in diameter (microcarcinoma) and without extrathyroidal tumor growth. Thus a limited radical resection (lobectomy) in these patients is sufficient. Operative morbidity in completion thyroidectomy is several times higher than in primary operation. Analogous to the defined low-risk group a reoperation in patients with postoperative incidental finding of a microcarcinoma is not necessary. In all other patients a completion thyroidectomy is indicated.