Rebecca l. Brown (23) consider total thyroidectomy the treatment of choice because prospective studies have showed increased and decreased disease-free period of relapse, even allowing for the treatment ablation with iodine 131 (21�C22). We believe, from the literature given the high incidence of multicentric SB203580 tumors (30�C85%), and the percentage relatively low complications, according to some authors, (9, 6, 23) always make the total thyroidectomy (TT) because: – in 40�C70% of cases there are microscopic foci in the contralateral lobe; – Total thyroidectomy removes the entire thyroid tissue allowing: the use of thyroglobulin recurrence as a cancer or distant metastasis marker; easier replacement therapy with thyroxine; effective ablative treatment with radioiodine; – TT reduces the chance of anaplastic or poorly differentiated tumor in residual parenchyma; – the correct assessment of medium or low risk is only postoperative, on the basis of tumor size and extracapsular infiltration (3, 4).

Conclusions As unanimously recognized, the goal of an adequate surgical approach to DTC is to: remove the primary tumor and lymph nodes affected by the disease; to minimize the morbidity related to treatment; to facilitate the staging of the disease, and the treatment with 131 I (9); to allow an accurate surveillance in the long term; and reduce the risk of recurrent disease and metastatic spread. Then we consider TT appropriate for DTC, considering the possible multifocality and dissemination in lymph nodes of the central compartment also for tumors with a diameter <1 cm that the approach.

However, surgery should consist in the execution of total thyroidectomy and central compartment lymphadenectomy when pathological. In this context, the formulation of guidelines and a multi-disciplinary approach allows more uniform and shared approach to diagnostic work up and treatment and more meaningful comparison of the data.
Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome, is an inherited autosomal dominant condition with high penetrance and variable expressivity. It was first described in 1960 by Gorlin and Goltz in a patient with multiple dermatological lesions associated with jaw cysts, subsequently defined as primordial (1�C3). Estimates of the incidence of NBCCS in the general population vary between 1:57,000 and 1:150,000 (4).

This variability is undoubtedly due to the wide range of clinical signs associated with the syndrome. A typical characteristic of NBCCS is the development of multiple basal cell carcinomas (BCC), with up to 100 or more arising in the same individual; 0.4% of all cases of basal cell carcinoma arise in patients with this syndrome (5). We report a case of NBCCS diagnosed in an adult man and subsequently, through genetic analysis, in one of his two Batimastat children.