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It has been estimated that approximately 5% to 20% of patients with differentiated thyroid carcinoma experience a recurrence of the cancer after treatment. Thyroid cancer can recur at the site of the thyroidectomy (thyroid bed) or in the regional lymph nodes of the neck.

The first-line treatment for recurrence of thyroid cancer is surgery to remove the tumor followed by radioactive iodine therapy. In cases where the recurrent tumor is inoperable (cannot be removed by surgery) or can only be partially removed by surgery, radioactive iodine therapy is the primary treatment modality. If the patient does not respond to Iodine-131 therapy, external-beam radiation therapy may be used to shrink the tumor.

Metastatic spread of differentiated thyroid carcinoma has been estimated to occur in 5% to 23% of patients. The most common sites of metastases are the lungs and bones. Depending upon the location and extent of the metastases, surgical excision to remove the tumor may be considered as an option for some patients. In most cases, however, treatment for distant metastases usually involves repeated doses of Iodine-131 administered at intervals of 3 to 9 months. In general, younger patients with metastatic differentiated thyroid cancer who are treated with repeated doses of Iodine-131 have a better prognosis (outlook) than older patients. Early detection and treatment of metastatic thyroid cancer can improve the likelihood for a successful outcome.