Thyroid cancer causing death after 40 years: rationale for initial intensive treatment.

Abstract

Three cases of death after 40 years of differentiated thyroid cancer are presented. Prolonged follow-up identified relapses in patients assumed to have been cured. Thus the case is argued for intensive initial therapy comprising near-total thyroidectomy (including excision of any macroscopic nodal disease) and ablative iodine-131 therapy in addition to thyroid hormone suppression.