Papillary carcinoma can be diagnosed preoperatively by ultrasound and fine needle aspiration. The referring endocrinologist may make an additional recommendation for postoperative radioiodine ablation with I-131. This can often be done as an outpatient. For this reason, a recommendation for a total thyroidectomy may occur at the time of diagnosis. Research continues to look at this issue, especially in low risk patients of younger age with smaller dominant masses.
Follicular cancer is the second most common form of thyroid cancer.
It arises from the follicular cells of the thyroid and may be associated with benign masses such as goiters. Follicular cancer is hard to diagnose pre-operatively, as there are no cellular characteristics that lend themselves to diagnosis by FNA as occurs with papillary cancer. The diagnosis of follicular cancer requires a complete and throuugh evaluation of the surgically removed specimen, therefore, the diagnosis may not be made for three to five days after surgery by the pathologists. Therefore, the experience of the operating endocrine surgeon is paramount. The minimal surgical resection required for a one to two centimeter follicular cancer should be the removal of a lobe and isthmus of the thyroid.