Contemporary management of papillary carcinoma of the thyroid gland

The incidence of thyroid cancer is increasing by 4% per year. Thyroid cancer has become the eighth most common malignancy diagnosed in women. Papillary cancer accounts for 80% of all thyroid cancer. The management of papillary thyroid cancer is challenging, primarily because there have been no prospective randomized trials to help guide therapeutic decision making. The purpose of this article is to discuss the contemporary management of papillary thyroid cancer, including the diagnosis and pre-operative evaluation, surgical management, postoperative thyroid hormone and radioiodine therapy, long-term follow-up, prognosis and management of recurrent and metastatic disease. The role of molecular markers to enhance the cytological diagnosis of papillary cancer and new molecular-based therapies will also be reviewed.