Most thyroid tumours are treated surgically with follow up radioiodine ablation if the tumour will concentrate I-131.
Papillary and follicular tumours are usually treated by near total or total thyroidectomy. An ipsilateral total lobectomy and isthmusectomy is indicated if only one lobe is affected. Following surgery, most centres will then ablate all residual functioning thyroid tissue with radioactive iodine over a period of 6-12 months. Others would propose administering suppressive doses of thyroxine and monitoring the patient for possible recurrence but this has become less fashionable recently.
Medullary and anaplastic tumours do not generally take up I-131 and are both treated by total thyroidectomy. Cervical lymph node dissection and external irradiation may also be performed.
Last reviewed 01/2018