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Surgery Endocrinology and breast 933f153f

Carcinoma thyroid localized and well differentiated, treatment consists of

A
Near total thyroidectomy, radioisotope
B
Subtotal thyroidectomy with external beam irradiation
C
Near total thyroidectomy, iodine, external beam irradiation
D
Total thyroidectomy, external beam radiation, life long eltroxin
High-Yield Explanation
The primary treatment of DTC (differentiated thyroid cancer) , is surgical ablation. The other mainstays of therapy are RAI ablation and TSH suppression. A patient diagnosed with PTC will undergo either total or near-total thyroidectomy as the preferred initial treatment. Therapeutic neck dissection is performed with initial thyroidectomy for patients with PTC with neck node metastasis. Adjuvant therapy includes postoperative TSH suppression with thyroxine therapy. If the patient is considered low risk, TSH levels are acceptable into the low range of normal. High-risk patients are often maintained at <=0.1 mIU/L. Postoperative radioactive abalation is reserved for patients with high-risk PTC or patients with a diagnosis of follicular or HCC (huhle cell cancer). External beam radiation therapy is used in patients with reccurrence or metastasis that is not amenable to surgery. Also is tried in patients with anaplastic carcinoma. Source : Devita Principles of Oncology 10th edition : Pg 1182

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