THYROID CANCER: CLINICAL EVALUATION, ENDOCRINOLOGICAL MANIFESTATIONS AND SURGICAL MANAGEMENT

Abstract

Thyroid cancer is more common in women and people over 40, but it can affect anyone. There are different types of thyroid cancer, the most common being differentiated carcinomas (papillary and follicular), which have a good prognosis and respond well to treatment. The clinical evaluation of thyroid cancer involves taking anamnesis, physical examination, measuring thyroid hormones and performing imaging tests and biopsy. The main symptom of thyroid cancer is the appearance of a nodule in the cervical region, which may be palpable or visible. The main surgical modalities are total thyroidectomy, which consists of complete removal of the thyroid gland; partial thyroidectomy or lobectomy, which consists of removing only part of the gland; and lymphadenectomy, which consists of removing lymph nodes affected by cancer. Objective: to synthesize the scientific evidence available on clinical assessment, endocrinological manifestations and surgical management in thyroid cancer. Methodology: based on the PRISMA checklist, the PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were: “thyroid cancer”, “thyroid neoplasm”, “clinical evaluation”, “surgical management” and “endocrinological manifestations”. Original studies in English or Portuguese that addressed the clinical, endocrinological or surgical aspects of thyroid cancer in humans were included. Studies that did not meet the inclusion criteria, were duplicates, had low methodological quality or did not have access to the full text were excluded. Results: 18 studies were selected, which revealed that thyroid cancer is a disease that presents different clinical, endocrinological and surgical aspects, depending on the type, stage and response to treatment. The studies analyzed provided evidence on diagnostic methods, indications and surgical techniques, the efficacy and safety of radioactive iodine therapy, and the role of suppressive hormone therapy in differentiated thyroid cancer. Conclusion: Thyroid cancer is a heterogeneous disease that requires a multidisciplinary approach for its diagnosis and treatment. The systematic review showed that there is consistent evidence on diagnostic methods, surgical modalities and radioactive iodine therapy in differentiated thyroid cancer. However, there are gaps in knowledge about the endocrinological manifestations of thyroid cancer and therapeutic alternatives for more complex or aggressive cases. Therefore, more studies are needed to clarify these aspects and improve the clinical management of patients with thyroid cancer.