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Surgical Treatment of Differentiated Thyroid Carcinoma Originating in the Isthmus (a Literature Review)

Papillary thyroid carcinoma originating in the isthmus accounts for 1.0%-9.2% of papillary thyroid carcinoma.There is no specific thyroid cancer originating in the isthmus treatm-ent guidelines including American Thyroid Association (ATA), British Thyroid Association (BTA), European Thyroid Asso-ciation (ETA). The characteristics of thyroid cancer in isthmus was as follows:1 Thyroid carcinoma of the isthmus is more likely to invade the capsule, multifocal lesions and central lymph node metastasis. 2 Expanded resection of the isthmus is only applicable to selected cases. Most isthmus cancers unde-rgo total thyroidectomy. 3 Papillary thyroid carcinoma is a low-grade malignant tumor with rare distant metastases. It is mainly metastasized to the lungs and bones and the prognosis is poor. 4 There is no report of distant metastasis of thyroid isthmus. Conclusions:1 Thyroid isthmus cancer is still a malig-nant tumor with a good prognosis. 2 Biological characteristics: multifocal; easy to central lymph node metastasis (anterior larynx, pretrachea); easy to invade the capsule, resulting in tracheal, ribbon muscle invasion; tumor diameter size with central lymph node metastasis was not significantly related. 3 Surgery is still controversial, with total thyroidectomy+ bilate-ral central area dissection, some patients consider extended thyroid isthmusectomy.