The approaches and challenges in the management of differentiated thyroid carcinoma

Purpose of review Whilst the prognosis of thyroid carcinoma remains excellent, patients with advanced thyroid carcinoma have a considerable burden of disease. Clinicians continue to face and manage challenging scenarios in the setting of thyroid cancer, particularly in those with recurrent disease, metastatic disease or special scenarios such as thyroid cancer in pregnancy. The purpose of this article is to provide an overview of thyroid cancer management and an update in emerging areas of management, particularly in the setting of locally advanced disease. Recent findings Systemic treatment of thyroid malignancy, particularly in the setting of locally advanced thyroid cancer, is rapidly evolving. Advances in targeted therapy have allowed for previously unresectable thyroid malignancies to undergo surgery, with significant increases to disease-free survival. Genomic profiling of tumours allows for specific mutations to be targeted with promising results for this cohort of patients. Summary This overview of the current management of thyroid carcinoma pays close attention to differentiated thyroid malignancy, with summaries of assessment, work-up and surgical management. Focus is made to the scenarios that continue to challenge clinicians, with up-to-date summaries of recent advances in this field.