The objections raised against simple lobectomy are the possibility of the presence of an occult tumour in the apparently normal lobe and the need to ablate the thyroid for follow-up scans and treatment of metastases that might arise. The arguments in favour of simple lobectomy are that recurrences or new primaries in the residual lobe do not occur after the operation in cases of microangioinvasive follicular carcinoma and are very rare in cases of intrathyroid papillary carcinoma. If metastases are subsequently found on clinical follow-up, it is possible to ablate the residual lobe and still treat these very slow-growing tumours. The more conservative approach in young patients, and the more radical approach in patients over forty years of age at the time of initial diagnosis, should be favoured.
