Thyroid cancer is a prevalent type of endocrine cancer, with a 1.2% rise in incidence in the United States in 2022. Women have a three-time higher incidence than men.1,2 The majority of cases are differentiated thyroid cancer (DTC), of papillary or follicular histology, which are slow-growing tumors. In most patients, the disease course is indolent (90%-95%), but a subgroup of patients (5%-10%) may experience an aggressive course with higher risk of recurrence.3, 4, 5 Papillary thyroid carcinoma tends to spread to nearby lymph nodes and the lungs. Tumor involvement of small central lymph nodes has minimal impact on the prognosis as it can be easily treated with surgery. However, if the disease spreads to lateral cervical or mediastinal nodes, the prognosis is worse. Hematogenous spread to the lungs poses a significant risk for persistence and recurrence. Metastases to the bones and brain are less common, but they result in an unfavorable outcome. Follicular thyroid carcinoma metastasizes more often hematogenous with the involvement of bones, lungs, brain, and other visceral organs.6,7 The American Thyroid Association (ATA) has divided DTC into three groups with varying risks of recurrence: ATA low risk (<5%), ATA intermediate risk (5%-20%), and ATA high risk (>20%).5 The 5-year survival rate is 99.9% for localized disease, 98.3% for regional metastasis, and 54.9% for distant metastasis.2

For patients with DTC thyroid cancer, surgery is considered the first-line treatment.5 Post-surgery management, which is considered the standard of care, involves radioactive iodine (RAI) therapy with iodine-131 (I-131) and thyroid hormone therapy. In instances where the tumor does not respond to RAI, additional treatments may be necessary, such as reoperation of the neck, external beam radiotherapy, interventional radiology ablation for treating locoregional metastases, and a combination of BRAF and MEK inhibitors.5,8, 9, 10, 11, 12