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-  2018 

In the Pursuit of the Perfect Thyroid Care - In the Pursuit of the Perfect Thyroid Care - Open Access Pub

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Abstract:

DOI10.14302/issn.2574-4496.jtc-18-1986 Since the first thyroidectomy was described in 912 AD by Abu al-Qasim, considered Islam′s greatest medieval surgeon, many things have changed in the field of thyroidology (fortunately for us).1 Going through Leonardo Da Vinci′s early drawing , showing it as an anatomical organ, not of a human exactly, and Thomas Wharton giving the name to the gland, as we spell it today, hinting the shape of an ancient Grecian shield, both described from the beginning of the XV century until the middle of the XVI century.2 There have been a series of epic events that have allowed a level of improvement in the management of thyroid diseases, both benign and malignant. The speed with which these scientific advances have been documented increased markedly from the nineteenth century after the discovery of the Iodine by Bernard Courtois and named as Iode by Gay-Lussac, right in the middle of the French Revolutionary Wars, a rhythm that has been maintained until the current date.3 Taking a more recent journey into the history of the events that spawned the current focus of well-differentiated thyroid cancer (DTC), we can see that after the first publication of the guidelines for the management of thyroid nodules and DTC by the American Thyroid Association (ATA) in 1966, there have been multiple advances in the diagnosis and management of such pathologies, and some of them have revolutionized the way in which our head and neck surgeons and the multidisciplinary team, in general, are trained today, in order to offer patients not only the best results in terms of prognosis, but under the perspective of attention to fine detail taking care of previously considered aspects as futile as the presence or not of a scar on the neck, and even the early use of high resolution imaging as the PET-CT in the follow-up of survivors. After the first description published by Tempka and collaborators in 1948 about the US-guided fine needle aspiration (US-FNA) as a diagnostic method, more than 50 years had to pass before there was another advance regarding the non-invasive evaluation of the thyroid nodule, which occurred after development of thyroid elastography in clinical application that was first reported by Rago et al in 2007, with several modifications after applying the different proposed scales and subsequently the appearance of shear wave elastography (SWE), described 7 years ago by Sebag, for the diagnosis of thyroid nodule and it does not convince many since it does not have reproducible cut-off values in the different studies that allow the

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