Chirurgische Therapie des verdächtigen Schilddrüsenknotens

Zusammenfassung

Für die chirurgische Therapie maligner Schilddrüsentumoren ist eine prä- und intraoperative Einschätzung der biologischen Bedeutung des Tumors entscheidend. So führen viele kleine papilläre Schilddrüsenmalignome selbst bei lymphogener Metastasierung zu keiner Beeinträchtigung der Lebenserwartung, während bei seltenen wenig differenzierten Schilddrüsenmalignomen der Patient akut gefährdet sein kann. Zusätzlich muss z. B. bei allen medullären Karzinomen eine mögliche familiäre Häufung mit Keimbahn- Mutation im RET-Protoonkogen beachtet werden, damit auch betroffene Angehörige frühzeitig effektiv therapiert werden können. Insgesamt basieren damit die heute angebotenen effektiven und individuell angepassten chirurgischen Therapieformen einzelner Schilddrüsenkarzinome auf vorhandenen Grundlagenerkenntnissen und den Ergebnissen klinischer Studien.

Abstract

Surgical therapy of malignant thyroid tumors has to focus on biologic importance of these distinct tumor entities. Thus small papillary thyroid cancer may not interfere with patient prognosis even in case of lymphatic metastasies, whereas dedifferentiated thyroid cancer directly may threaten patient’s lives. And in each case of medullary thyroid cancer familiarity (ret-proto-oncogene mutation) needs to be assessed to ascertain early treatment of involved family members. Thus personalized surgical management of patients with thyroid cancer follows knowledge of basic pathophysiologic understanding and the results of clinical trials.

Schlüsselwörter

verdächtige Schilddrüsenknoten - Schilddrüsenmalignome - Operation verdächtiger Schilddrüsenknoten

Key words

suspicious thyroid nodules - thyroid malignancy - operation of thyroid tumors

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