Special variants of differentiated thyroid cancer: Does it alter the extent of surgery versus well-differentiated thyroid cancer?

Introduction: Recently, more aggressive variants of so-called well-differentiated thyroid carcinomas have been identified such as the tall cell variant, columnar cell variant, diffuse sclerosing variant, insular carcinoma, and Hurthle cell (oncocytic, oxyphilic) carcinomas. Methods: An evidence-based review was performed to identify the optimal treatment recommendations for these thyroid cancers of intermediate differentiation. Conclusions: Although some variation exists within the group, aggressive surgical and medical management are recommended for these neoplasias. Any such recommendations should, however, be viewed in the light of the fact that the current literature mainly consists of case reports, case series, and limited reviews. The clinical presentation, pathophysiology, diagnosis, and surgical and medical management for these thyroid cancers with intermediate differentiation are discussed.