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INCIDENTAL THYROID CARCINOMA IN A LARGE SERIES OF CONSECUTIVE PATIENTS OPERATED ON FOR BENIGN THYROID DISEASE
Author(s) -
Miccoli Paolo,
Minuto Michele N.,
Galleri David,
D’Agostino Jacopo,
Basolo Fulvio,
Antonangeli Lucia,
AghiniLombardi Fabrizio,
Berti Piero
Publication year - 2006
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2006.03667.x
Subject(s) - medicine , thyroid , goiter , euthyroid , thyroid carcinoma , thyroid nodules , incidence (geometry) , carcinoma , thyroid disease , radiology , surgery , physics , optics
Background: The diagnosis of incidental thyroid carcinoma (ITC) in patients operated on for a benign disease is frequent. This study aims to determine both its clinical effect and the possibility of identifying this class of patients preoperatively. Methods: A total of 998 consecutive patients (697 women and 301 men; mean age, 49.5 years) undergoing surgery for benign thyroid pathology in a single institution were studied. The mean time between first diagnosis of thyroid disease and operation was 9.0 years (range, 0–50 years). All patients underwent at least one ultrasonography before surgery, and 678 patients underwent fine‐needle aspiration cytology. Patients with undetermined cytology or follicular nodules were excluded from the study. Results: Histology revealed an ITC in 104 patients (10.4%): 99 had a papillary carcinoma. Mean and median diameters of ITC were 1.4 and 0.7 cm, respectively (range, 0.1–7.5 cm). In 43 patients, the tumour size was greater than 1 cm, whereas it exceeded 2 cm in 25 patients. Tumours were multicentric in 19.8% of the patients and occurred in 8.2% of patients with nodular toxic goiter, 8.7% of patients with toxic diffuse goiter and 13.8% of patients with multinodular goiter. Discussion: The results confirm the high frequency of ITC. ITC was more frequent in euthyroid patients than in thyrotoxic patients ( P < 0.03). Sex, age, thyroid volume and interval between diagnosis and surgery did not significantly influence its incidence. The majority of ITC was represented by microcarcinomas, but in approximately 25% of patients, the tumour size was greater than 2 cm. The role played by FNAC in excluding malignancies proved to be fairly inconclusive.