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Adults with Differentiated THyroid Cancer - 2025 Update

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Tables and Figures 30 Table 4. Syndromes Associated With DTC Syndrome (gene) Histology Lifetime risk Other features Screening guidance Cowden/ PTHS syndrome (PTEN) FTC a , PTC 3–10% Breast cancer, endometrial cancer, goiter, macrocephaly NCCN – Genetic/ Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic Familial adenomatous polyposis (APC) CMTC, PTC Up to 12% Colon polyposis, CHRPE, desmoids NCCN – Genetic/ Familial High-Risk Assessment: Colorectal DICER1 tumor predisposition (DICER1) PTC, FTC a , PDTC OR, 9.2 [CI, 2.1–34.7] Pleuropulmonary blastoma, cystic nephroma, ovarian sex cord stromal tumors Schultz et al. Clin Cancer Res 2018;24(10):2251- 2261, doi: 10.1158/1078-0432. Ccr-17-3089 Carney complex (PRKAR1A) FTC a , PTC Unknown Pigmented abnormalities of the skin, myxomas, schwannomas, and endocrine tumors Correa et al. Eur J Endocrinol 2015;173(4):M85–97, doi: 10.1530/eje-15- 0209 Werner syndrome (WRN) FTC a , PTC Unknown Premature aging, cataracts, DM, other cancers Takemoto et al. Geriatr Gerontol Int 2021;21(2):131–132, doi: 10.1111/ggi.14074 a OTC was previously included as a subtype of FTC and is likely also associated with these hereditary predispositions. Table 5. Extent of Initial Thyroid Surgery for DTC Clinical stage Extent of thyroidectomy a cT1N0M0 (Unilateral) Lobectomy cT1(m)N0M0 (Bilateral) Total thyroidectomy cT2N0M0 (Unilateral) Lobectomy or Total thyroidectomy cT2(m)N0M0 (Bilateral) Total thyroidectomy cT3–4 or cN1 or cM1 Total thyroidectomy Clinical stage based upon AJCC 8th edition. a If surgery chosen for initial therapy.

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