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Laura Fugazzola Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Maurilio Deandrea Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, Ordine Mauriziano Hospital, Turin, Italy

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Stefano Borgato Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Marco Dell’Acqua Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Francesca Retta Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, Ordine Mauriziano Hospital, Turin, Italy

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Alberto Mormile Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, Ordine Mauriziano Hospital, Turin, Italy

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Chiara Carzaniga Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Giacomo Gazzano Pathology Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Gabriele Pogliaghi Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Marina Muzza Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Luca Persani Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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perform a molecular testing, or a diagnostic lobectomy, or an active surveillance. Few papers have been published reporting the efficacy of thermo- or microwave ablation in this class of nodules, but only small (volume range: 1.9–7.9 mL) and genetically

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Giovanni Mauri Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy

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Laszlo Hegedüs Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark

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Steven Bandula Interventional Oncology Service, University College Hospital, London, United Kingdom

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Roberto Luigi Cazzato Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France

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Agnieszka Czarniecka The Oncologic and Reconstructive Surgery Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland

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Oliver Dudeck Center for Microtherapy, Klinik Hirslanden, Zurich, Switzerland

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Laura Fugazzola Department of Endocrinology and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Romana Netea-Maier Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

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Gilles Russ Thyroid and Endocrine Tumors Unit, La Pitie-Salpetriere Hospital, Sorbonne University, Paris, France

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Göran Wallin Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

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Enrico Papini Department of Endocrinology & Metabolism, Ospedale Regina Apostolorum, Albano, Italy

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the frequently indolent nature of PTMC and the cost and risk of surgery, active surveillance (AS) and ultrasound (US)-guided minimally invasive treatments (MITs) are proposed as alternative management options to thyroidectomy for selected incidental

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L.A. Jonker Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

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C.A. Lebbink Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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M.C.J. Jongmans Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands

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R.A.J. Nievelstein Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Department of Pediatric Radiology and Nuclear Medicine, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

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J.H.M. Merks Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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E.J.M. Nieveen van Dijkum Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands

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T.P. Links Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands

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N. Hoogerbrugge Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands

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A.S.P. van Trotsenburg Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands

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H.M. van Santen Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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in Children with PHTS Improve Outcome? If early detection of DTC improved outcome, this would be an argument for an active surveillance program. No evidence for improved outcome was found for PHTS children and for children in the International

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Syed Ali Imran Division of Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada

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Karen Chu Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

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Murali Rajaraman Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada

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Drew Rajaraman Division of Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada

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Sunita Ghosh Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

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Sarah De Brabandere Department of Diagnostic Imaging, Western University, London, Ontario, Canada

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Stephanie M. Kaiser Division of Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada

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Stan Van Uum Department of Medicine, Western University, London, Ontario, Canada

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studies have suggested that “active surveillance” of select low-risk DTC [ 17 , 27 ] instead of an aggressive initial treatment such as surgery and/or I-131 therapy does not change the outcome in the short to medium term. However, the long-term safety of

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Yalin Iscan Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

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Ismail Cem Sormaz Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

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Fatih Tunca Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

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Yasemin Giles Senyurek Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

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death of the patients in 0.6% of the cases [ 7 - 11 ] . The management of PMC in the literature may vary from active surveillance without surgery in selected patients to a total thyroidectomy with or without radioactive iodine treatment [ 12 ]. Lobectomy

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Maria Mavromati Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland

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Essia Saiji Department of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Marco Stefano Demarchi Department of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Vincent Lenoir Department of Radiology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Amanda Seipel Department of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Paulina Kuczma Department of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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François R Jornayvaz Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland

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Minerva Becker Department of Radiology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Eugenio Fernandez Department of Oncology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Claudio De Vito Department of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Frédéric Triponez Department of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, Switzerland

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Sophie Leboulleux Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, Switzerland

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with surgery, active surveillance, or local treatment, depending on the size of the nodule ( 3 , 4 , 5 , 6 ). Given the high rate of thyroid nodules, most of which are benign, to reduce fine needle aspiration cytology (FNAC) and unnecessary surgery

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Carla Gambale Department of Clinical and Experimental Medicine, Unit of Endocrinology, Pisa University Hospital, Pisa, Italy

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Alessandro Prete Department of Clinical and Experimental Medicine, Unit of Endocrinology, Pisa University Hospital, Pisa, Italy

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Chiara Romei Department of Diagnostic Imaging, Unit of Radiology, Pisa University Hospital, Pisa, Italy

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Alessandro Celi Department of Surgery, Medicine, Molecular Biology and Critical Care, Respiratory Pathophysiology Unit, Pisa University Hospital, Pisa, Italy

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Rossella Elisei Department of Clinical and Experimental Medicine, Unit of Endocrinology, Pisa University Hospital, Pisa, Italy

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Antonio Matrone Department of Clinical and Experimental Medicine, Unit of Endocrinology, Pisa University Hospital, Pisa, Italy

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distant metastases were detected. Therefore, an active surveillance strategy was chosen. At the following evaluation (June 2020) CTN values increased (3254 ng/L) and 2 small (<1 cm) suspicious liver metastases were detected by abdomen magnetic resonance

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Dong Jun Lim Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea

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Won Bae Kim Department of Internal Medicine, Asan Medical Center, Korea

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Bo Hyun Kim Department of Internal Medicine, Pusan National University Hospital, Busan, Korea

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Tae Yong Kim Department of Internal Medicine, Asan Medical Center, Korea

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Young Suk Jo Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea

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Ho-Cheol Kang Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea

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Young Joo Park Department of Internal Medicine, Seoul National University Hospital, Korea

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Ka Hee Yi Department of Internal Medicine, Korea Cancer Center Hospital, Korea

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Minho Shong Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea

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In Joo Kim Department of Internal Medicine, Pusan National University Hospital, Busan, Korea

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Do Joon Park Department of Internal Medicine, Seoul National University Hospital, Korea

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Sun Wook Kim Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Jae Hoon Chung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Jaetae Lee Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea

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Sung-Soo Koong Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea

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Young Kee Shong Department of Internal Medicine, Asan Medical Center, Korea

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surveillance of cancer recurrence during the follow-up period in DTC patients [ 4 , 5 ]. However, in many Asian countries including Korea, using rhTSH in those situations is restricted mainly due to its high costs and reimbursement issues [ 6 ]. Given the

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Brigitte Decallonne Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium

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Annick Van den Bruel Department of Endocrinology, General Hospital St Jan, Bruges, Belgium

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Gilles Macq Department of Research, Belgian Cancer Registry, Brussels, Belgium

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Nathalie Elaut Department of Research, Belgian Cancer Registry, Brussels, Belgium

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Harlinde De Schutter Department of Research, Belgian Cancer Registry, Brussels, Belgium

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surgical selection. Our study underlines the importance of monitoring implementation of international guidelines, especially in an ever-evolving era of thyroid cancer management, where even active surveillance is increasingly advocated in case of very low

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Cosimo Durante Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

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Laszlo Hegedüs Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Agnieszka Czarniecka M. Sklodowska-Curie National Research, Institute of Oncology Gliwice Branch, Gliwice, Poland

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Ralf Paschke Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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Gilles Russ Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne University GRC N°16, Paris, France

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Fernando Schmitt Faculty of Medicine of University of Porto, CINTESIS@RISE and Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), Porto, Portugal

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Paula Soares Institute of Investigation and Innovation in Health (I3S), Faculty of Medicine of the University of Porto, Porto, Portugal

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Tamas Solymosi Endocrinology and Metabolism Clinic, Bugat Hospital, Gyöngyös, Hungary

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Enrico Papini Department of Endocrine and Metabolic Diseases, Regina Apostolorum Hospital, Albano, Rome, Italy

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–benefit ratio ( 5 , 6 , 7 ). A more conservative approach results in reduced cost as well as a lower risk of complications ( 8 , 9 ). Implementation of active surveillance and minimally invasive techniques (MITs) has been limited and measured ( 10

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