Surgical cases that can be safely deferred:
- Differentiated thyroid cancer***
- Medullary thyroid cancer***
- Indeterminate thyroid nodules without documented progression
- Thyroid goiters**
- Primary hyperparathyroidism
- Medically-controlled hyperfunctioning endocrine tumors
- Incidental, nonfunctional adrenal lesions
*Anaplastic thyroid cancer patients with BRAFV600E mutations
should be offered BRAF/MEK inhibitor therapy initially and surgery can
be deferred12.
**Generally, mildly symptomatic airway compression from large goiters is
subacute or chronic, and does not require immediate intervention. Very
rarely, a patient may present with significant and acute airway
compromise, in which case surgery or airway intervention cannot be
safely postponed.
***Most differentiated and medullary thyroid cancers are slow-growing
tumors that don’t cause significant morbidity over the short-term,
although there are a subset of more biologically aggressive cancers that
progress more rapidly. Therefore, clinical correlation with rate of
progression (if known), size, invasiveness of surrounding structures,
and proximity to critical structures is recommended.
Phase II. Many COVID-19 patients, ICU and ventilator capacity limited, and/or
Operating Room supplies limited.