Thyroid oncology in pregnancy

Abstract

Thyroid cancer is the second most commonly diagnosed malignancy during pregnancy (after breast cancer), with 14 cases per 100,000 pregnancies. It is always a challenge for clinicians, requiring special consideration and attention for both the patient and her developing child. The main protocols for diagnosing and treating thyroid cancer in pregnancy are the same as in cases diagnosed in the rest of the population, with some restrictions: administration of radioactive iodine (RAI) as a part of therapy is forbidden. There are many aspects that should be discussed regarding thyroid malignancy during pregnancy, such as the timing of surgery, systemic therapy for thyroid cancer during pregnancy and the effect of pregnancy on thyroid cancer outcomes. The influence of RAI ablative therapy and therapy with levothyroxine (LT4) after thyroid cancer treatment should be considered in relation to possible future pregnancies. The aim of this study was to evaluate the recent literature and guidelines regarding thyroid malignancy in pregnancy, and to provide answers to these questions.