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The optimal management of structurally identified neck disease after initial surgery for thyroid carcinoma is nuanced and must be individually tailored to the patient and his or her disease. As such, it is ideally evaluated and managed with the patient from an experienced interdisciplinary program perspective. Proficiency and focused expertise in diagnostic imaging (ultrasound, cross-sectional, and nuclear), pathology, surgery, endocrinology, radiation oncology, and systemic therapy are integral components of such a program. A thorough understanding of the risks of the disease and treatment options, including management of complications, is required. While no single algorithm is available, several large series, systematic reviews, and guidelines have been published, from which some generalities can be gleaned.1- 8
Clayman GL, Steward DL. Management of Persistent or Recurrent Structural Neck Disease in Differentiated Thyroid CarcinomaPoint and Counterpoint. JAMA Otolaryngol Head Neck Surg. 2016;142(8):789-791. doi:10.1001/jamaoto.2016.1114