I. Our (microscopic thyroid cancer) character We are the most well-behaved babies in the cancer family, often staying quietly in people’s thyroid gland, not willing to run around and growing slowly, so it is hard to be detected by people. We used to be often found in autopsies after people died from other causes, and according to the literature?? The detection rate of autopsy is 2.0%~35.6%, so people call us “hidden cancer”. Nowadays, with the enhancement of people’s health awareness and the application of high-resolution color ultrasound, we are more and more discovered, even to a few millimeters, and people can identify our true nature through fine needle biopsy and pathological cytology diagnosis. We are almost “stars”. According to research data, up to 60,220 cases of my siblings (thyroid cancer) were newly discovered in the United States in 2013 and nearly 90,000 cases of our siblings (thyroid cancer) were newly discovered in China in 2015, of which more than 1/2 of the newly discovered siblings (thyroid cancer) were us, the good babies (thyroid micro papillary cancer). Of course, there are a very few of us who are bad boys and girls who don’t stay in the thyroid gland and want to go outside the thyroid gland and run to the lymph nodes around the thyroid gland and set up camp there to cause trouble. But the bad boys will rarely put people to death like other cancer family bastards, and will often coexist peacefully with people for many years. What people do when they find us (microscopic cancer)? When people find us, they will often try to invite us out, and there are many ways to invite us out: 1. Uprooting method: In the past, when people invited us out, they would often drive us out together with all the thyroid glands, meaning to remove them completely, leaving no room for us to live, and uproot us. Most of us will leave people with the thyroid gland, but there are a few naughty bad boys who will hide quietly and then slowly sprout, flower and bear fruit in the lymph nodes of people’s necks and thyroid beds without the thyroid gland, and when people find us, they will operate again to take us all out, but they also pay a big price for this: people will be left with unsightly scars on their necks, and they will lose their thyroid gland. People will lose their thyroid gland and take medication for the rest of their lives to replenish thyroid hormones, they may have hoarse speech (damage to the recurrent laryngeal nerve), and they may have convulsions (damage to the parathyroid glands). Despite all the efforts (surgical removal, iodine 131 therapy, hormone suppression therapy) to get rid of the disease, a few stubborn people will stay. Seeing people pay such a high price to remove us while there are still small partners can hide down are a little embarrassed. 2, quiet observation method: As people know more and more about us, with the improvement of people’s technology, people began to realize that most of us are good, peaceful, and can get along with people in peace. So it was proposed that we could be allowed to stay in people’s thyroid gland without harming us, but instead we could be quietly observed and then uprooted (total thyroidectomy plus cervical lymph node dissection) once any troublemakers slipped outside the thyroid gland. Japanese Ito et al. 2003 reported the results of 340 cases of observation of us (micro papillary thyroid carcinoma) with a mean follow-up time of 74 months. Compared with the control group that underwent surgery, no significant differences were observed in various indicators such as lymph node metastasis and prognosis in the observation group. The Japanese Ito et al. 2012 reported the results of another 6-year follow-up observation of 1235 cases of us (microscopic thyroid cancer), and he found 58 cases (4.6%) of us (lesions) that had enlarged and 19 cases (1.5%) of us that had run outside the thyroid (new lymph node metastases). Since there are fewer bad guys among us, it has been proposed to observe only our practice. 3, retain part of the thyroid gland removal method: As people gradually understand the characteristics of our character and see the harm of completely losing the thyroid gland to people, they began to take a less harmful human removal method, only one lobe of the thyroid gland where we live will be removed with us, while retaining the other good side of the thyroid gland for people’s quality of life, but the scar in the neck still exists, and the thyroid function will be a little Many beauty lovers are not willing to accept it, such as young beauty, special people (actors, announcers, public figures, etc.) and unmarried men and women. So people have created a way to remove us and the thyroid gland we live in by means of a lumpectomy playing a channel under the skin to meet the needs of beauty lovers, but this technology only meets the needs of beauty, and its trauma is no less than or even greater than open surgical excision. 4.Thermal ablation method: Thermal ablation was applied to the treatment of malignant tumors such as liver cancer and lung cancer in cancer family as early as 80s, and it can achieve the effect comparable to surgical resection, because cancer family is too sensitive to heat, 45℃ is too much for most cancer family members to bear. And thermal ablation (including microwave, radiofrequency, laser ablation) can insert ablation needle directly into tumor tissues through the guidance of images (ultrasound, CT) etc. The local temperature can reach 80-100℃, and instantly tumor tissues are coagulated and necrosed and microcirculation is destroyed. We (microscopic thyroid cancer), who are small and weak, cannot withstand this kind of “thermal cauterization” and will be “burned to death” in the same place after 1-2 minutes, and the ablation range will be expanded and the surrounding thyroid tissue will be destroyed together with us. It will be destroyed together with the surrounding thyroid tissue where we live, making it too late for us to run. After a week or so our “corpse” will disintegrate and the giant cells in our body will come to us, the fibrous tissue will wrap around our “corpse” and the human body will devour us little by little, after six months to a year we will disappear without a trace. We will disappear without a trace. After the thermal ablation we are removed and the thyroid gland is intact and the neck is scarless, as if we had never been here, and this method is increasingly accepted. 5.Hormone suppression therapy: The thyroid stimulating hormone secreted by human body is our (microscopic thyroid cancer) favorite thing, we depend on it to grow and without it we can hardly take root, sprout and bear fruits. People know our weakness and use a drug called levothyroxine sodium tablets to lower the level of thyroid stimulating hormone to <0.1mU/L or below, in this state we have no room to live, just like the grass leaves the water and slowly withers away. 6.Thermal ablation combined with hormone suppression therapy: As mentioned before, these two together are fatal to us (microscopic thyroid cancer), people can first use thermal ablation to exterminate us completely, and then use hormone suppression therapy to gradually destroy our residual molecules and the bad boys who secretly want to stay, so that we can disappear completely. During this process people will also review us periodically and if they find any of our little friends left behind, they will also inactivate us again by thermal ablation. People through these methods to make us right in place, but also effectively protect people from damage themselves, really getting smarter and smarter. We (microscopic thyroid cancer) are often completely inactivated in situ and together with some thyroid tissues, usually by expanding the surrounding area by 0.5-25px. After inactivation, we can still see it on ultrasound, but it's already completely different, with uneven hypoechogenicity and no local contrast filling on ultrasonography, showing a "black hole". Color Doppler ultrasound showed no internal blood flow signal, as we had no vital signs. The pathology of the puncture biopsy showed connective tissue hyperplasia with inflammatory cell infiltration and multinucleated giant cell reaction around the degenerated thyroid follicle. Ultrasound review showed that the ablation zone was gradually reduced in extent and finally completely absorbed. People returned to a normal state.