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Limitations of preoperative cytology for medullary thyroid cancer: Proposal for improved preoperative diagnosis for optimal initial medullary thyroid carcinoma specific surgery
Author(s) -
Workman Alan D.,
Soylu Selen,
Kamani Dipti,
Nourmahnad Anahita,
Kyriazidis Natalia,
Saade Ryan,
Ren Yin,
Wirth Lori,
Faquin William C.,
Onenerk Ayşe M.,
Nikiforov Yuri E.,
AlQurayshi Zaid,
Kandil Emad,
Kloos Richard T.,
Eldeiry Leslie,
Lubitz Carrie,
Stathatos Nikolaos,
Randolph Gregory W.
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26550
Subject(s) - medicine , medullary cavity , medullary thyroid cancer , radiology , thyroid carcinoma , medullary carcinoma , cytology , thyroid nodules , thyroid , carcinoma , thyroid cancer , general surgery , pathology
Background Preoperative diagnosis of medullary thyroid carcinoma (MTC) is often difficult, given the poor sensitivity of fine‐needle aspiration (FNA) cytology for MTC. This study investigates this issue and presents recommendations for improving preoperative diagnostic paradigms in MTC cases. Design/Method Histopathologically confirmed MTC patients with preoperative cytologic assessment of index nodules were enrolled. FNA diagnosis, final pathology, and surgery details were collected. Results Out of 71 patients, 49 (69%) were diagnosed by FNA as either definitive MTC (35, 49%) or suspected MTC (14, 20%) and 22 (31%) patients had no indication of MTC on FNA. Conclusion In a tertiary‐care setting, one‐third of subjects had an FNA interpretation that did not suggest the possibility of MTC. The limitations of preoperative diagnosis are especially problematic for MTC as they can cause delayed or incomplete treatment. Additional testing is proposed to improve preoperative diagnosis and surgical care of MTC patients.