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Differentiated Thyroid Cancer

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Differentiated Thyroid Cancer 8 43. The parathyroid glands and their blood supply should be preserved during thyroid surgery. (SR-HM) 44. Patients should have their voice assessed in the post-operative period. Formal laryngeal exam should be performed if the voice is abnormal. (SR-M) 45. 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. (SR-L) 46. A) In addition to the basic tumor features required for AJCC/ UICC 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 node, and presence or absence of extranodal extension of the metastatic tumor. (SR-M) B) Histopathologic variants of thyroid carcinoma associated with more unfavorable (e.g. tall cell, columnar cell, and hobnail variants of PTC; widely invasive FTC; poorly differentiated carcinoma) or more favorable (e.g., encapsulated follicular variant of PTC without invasion, minimally-invasive FTC) outcome should be identified during histopathologic examination and reported. (SR-L) C) Histopathologic variants associated with familial syndromes (cribriform-morular variant of papillary carcinoma often associated with familial adenomatous polyposis, PTEN-hamartoma tumor syndrome associated follicular or papillary carcinoma) should be identified during histopathologic examination and reported. (WR-L)

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