Clinical Considerations of Oncocytic Thyroid Cancer: A Review

• 발행기관: 대한내분비외과학회
• 저자명: Soo Young Kim
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』24권3호, 49~55쪽, 전체 7쪽
• 주제분류: 의약학 > 면역학
• 파일형태: PDF
• 발행일자: 2024.09.30

국문 초록

The fifth edition of the World Health Organization (WHO) histological classification of thyroid neoplasms released in 2022 includes newly recognized tumor types, subtypes, and a grading system. The term “oncocytic thyroid carcinoma” (OTC) is used in the new WHO classification to refer to invasive malignant follicular cell neoplasms composed of at least 75% oncocytic cells in which the nuclear features of papillary thyroid carcinoma and high-grade features are absent. As there are no reliable preoperative or intraoperative markers to identify OTC, diagnostic surgery is indicated when OTC is suspected. As the diagnosis of OTC is made postoperatively, the histopathological diagnosis frequently raises the question of completion surgery. The National Comprehensive Cancer Network (NCCN) guidelines only recommend the completion of thyroidectomy for invasive cancer (widely invasive or encapsulated angioinvasion with ≥4 vessels). In other cases, such as the encapsulated angioinvasive type with <4 vessels or minimally invasive oncocytic carcinoma, disease monitoring is preferred. Given the low rate of lymph node metastases, the benefit of routine prophylactic central lymph node dissection remains unclear, especially in the absence of vascular invasion from the primary tumor. Data regarding treatment efficacy for metastatic OTC are limited. However, trials with systemic therapy with targeted kinase inhibitor therapy support the use of sorafenib and lenvatinib.

목차

INTRODUCTION

INITIAL SURGICAL PROCEDURES FOR OTC—IS DIAGNOSTIC SURGERY NEEDED?

IS CENTRAL COMPARTMENT NECK DISSECTION REQUIRED?

WHEN IS COMPLETION THYROIDECTOMY NEEDED?

IS RAI TREATMENT REQUIRED?

TREATMENT OF METASTATIC DISEASE

PROGNOSIS

CONCLUSION

REFERENCES

키워드

Thyroid cancer Thyroid cancer Hurthle cell Thyroid neoplasms Thyroid nodule Thyroidectomy