The unexpected thyroid cancer
Faculty of Medicine and Health Sciences
Jurnalul de chirurgie. - Ia«015F»i
, p. 61-64
University of Antwerp
Thyroid cancer has an increase incidence and prevalence. Aim: to evaluate the prevalence of unexpected / incidental thyroid cancer. Methods: retrospective study performed in three surgical centers, specialised in endocrine surgery. Results: 83 cases with thyroid cancer was retrospectively reviewed. Most cases were papillary cancer (54%), followed by follicular cancer (15%) and medullar cancer (4%). The incidence of unexpected thyroid cancer was 30.1%. The initial diagnosis were: multinodular goiter in 14 cases and cystic or adenomatous nodule in another 11 cases. The histologic type was papillar carcinoma in 16 cases and follicular cancer in the other 9 cases. The first operation was considered adequate in 10 cases, and in 15 cases a completion thyroidectomy was necessary. The postoperative morbidity of the second operation was 13.3%: unilateral recurrent nerve palsy 1 case and hypoparathiroidism 1 case. The recurrence rate was 20% (!), but all cases was succesfully treated by radioactive iodine. Conclusions: Unexpected thyroid cancer more frequent than previously thought (30.1%). A primary operation should best consist of total unilateral lobectomy for a benign nodule or unilateral goiter and total lobectomy associated with subtotal controlateral lobectomy for a cold nodule or multinodular bilateral goiter.