13
Recommendation 26
A. Patients should have their voice assessed in the post-operative
period. Formal laryngeal exam should be performed if the voice is
abnormal. (GPS)
B. Important intraoperative findings and details of post-operative care
should be communicated by the surgeon to the patient and other
physicians who are important in the patient's post-operative care.
(GPS)
C. If there is known recurrent laryngeal nerve injury from surgery,
timely referral to a speech language pathologist and physician
specializing in voice is recommended. (GPS)
Recommendation 27
A. In addition to the essential histopathologic features of the tumor
required for the latest AJCC thyroid cancer staging (including status
of resection margins), pathology reports should include additional
information helpful for risk assessment, including the presence of
vascular invasion and the number of invaded vessels, number of
lymph nodes examined and involved with tumor, size of the largest
metastatic focus to the lymph nodes, and presence or absence of
extranodal extension of the metastatic tumor. (GPS)
B. Histopathologic subtypes of DTC associated with unfavorable (e.g.,
tall cell, columnar cell, and hobnail subtypes of PTC; widely invasive
FTC and OTC; high grade follicular cell derived non-advanced thyroid
cancer [ATC]) or favorable (e.g., invasive encapsulated follicular
variant of papillary thyroid carcinoma [IEFVPTC] with minimal
invasion, minimally-invasive FTC) outcomes should be identified
during histopathologic examination and reported. (GPS)
C. Histopathologic subtypes associated with familial syndromes
(cribriform-morular carcinoma can be associated with familial
adenomatous polyposis, PTEN-hamartoma tumor syndrome
associated FTC or PTC) should be identified during histopathologic
examination and reported. (GPS)
