Surgery is the initial therapy in thyroid carcinoma. The basic principles of surgical oncology in malignant epithelial tumors have their full improvement in thyroid carcinoma (TC). The surgery is performed on organ of tumor origin and regional lymphatic basins. The aim of surgery in thyroid carcinoma is to eradicate all tumor foci, cure the most number of patients, reduce recurrence and mortality rate, and provide good quality of life. There is no doubt between oncologists that the surgery for

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... hyroid carcinoma has no alternative. The extent of surgery is matter of actual controversies. Surgery is the initial treatment for all differentiated, papillary and follicular, as well as medullary and even anaplastic thyroid carcinoma. It should be performed by well-trained surgeons. The surgery of thyroid gland is the surgery of laryngeal recurrent nerve and parathyroid glands. The extent of primary surgery should be dictated by stage of disease and prognostic factors. The quality of surgery and incidence of complications depends on surgeon's skill and experience. That is why the surgeon is factor of prognosis in treatment of patients with TC. greater than 2cm in diameter (33). Surgery for MTC, either preventive or curative, includes total thyroidectomy, bilateral central dissection and lateral lymph node dissection (MRND) according to frozen-section findings of lower two thirds of jugulo-carotid chain (29). However, surgery for MTC also includes visualization (methylene blue staining) and exploration of all four parathyroid glands. In cases of adenoma or hyperplasia the affected glands should be removed and histology examined. All MTC patients should be pre-operatively screened for pheochromocytoma (34).