PMID- 24742409
OWN - NLM
STAT- MEDLINE
DCOM- 20140725
LR  - 20140418
IS  - 1221-9118 (Print)
IS  - 1221-9118 (Linking)
VI  - 109
IP  - 2
DP  - 2014 Mar-Apr
TI  - Occult thyroid carcinoma in our experience -- should we reconsider total 
      thyroidectomy for benign thyroid pathology?
PG  - 191-7
LID - 6 [pii]
AB  - BACKGROUND: The reported incidence rate of occult thyroid carcinoma in patients 
      operated for benign thyroid pathology has been much higher than expected in the 
      last years,especially for multinodular goitre, which raises the question about 
      which should the proper surgical management for these cases be. AIM: To assess 
      the incidence rate of OTC in a single medium volume surgical center and to 
      establish the correct indication for initial surgical management, as well as to 
      identify the benign thyroid pathology most frequently associated with OTC. We 
      also reviewed the relevant scientific literature on this topic. MATERIAL AND 
      METHOD: We conducted a retrospective study in the General Surgery Clinic of 
      "Prof. dr. Agrippa Ionescu" Clinical Emergency Hospital, Bucharest, on a series 
      of 145 patients who underwent surgical interventions for preoperatively diagnosed 
      benign thyroid pathology over a ten year period, between 1st January 2002 - 31st 
      December 2012. All cases of known thyroid cancer were excluded. RESULTS: 
      Incidence rate of occult thyroid carcinoma in our series was 6.9 % (10 out of 145 
      patients), 80 % of them being diagnosed with multinodular goitre and two cases 
      (20 %) with Hashimoto's lymphocytic thyroiditis. 6.8 % of all patients with 
      multinodular goitre were found to present occult carcinoma,but this association 
      was without statistical significance(p 0.05). Incidence rate of occult cancer 
      among patients with Hashimoto thyroiditis was proved to be as high as 
      28.6%,statistically significant (p=0.020). The mean size of postoperatively 
      diagnosed occult microcarcinoma was 7 mm, ranging between 3 mm and 14 mm, 90% of 
      them being smaller than 1cm. Histologically, papillary microcarcinoma was found 
      in all cases. The mean age of the patients diagnosed with occult microcarcinoma 
      was 47.8 years with majority of the female gender. The most frequent operation 
      performed was total thyroidectomy (70.8%). Overall morbidity in our series was 
      6.9% with a 0.7 % mortality rate (1 case). CONCLUSIONS: In our opinion, primary 
      total thyroidectomy should be performed as the procedure of choice for the most 
      part of preoperatively diagnosed benign thyroid pathology and particularly for 
      multinodular goitre and Hashimoto thyroiditis,in order to radically resect all 
      possible foci of aggressive thyroid microcarcinomas.Abbreviations and Acronyms: 
      OTC (Occult Thyroid Carcinoma), PTMC (Papillary Thyroid Microcarcinoma); TT(Total 
      Thyroidectomy), MNG (Multinodular Goitre), GD(Graves' disease), TNG (Toxic 
      Nodular Goitre), FNAB(fine-needle aspiration biopsy).
CI  - Celsius.
FAU - Alecu, L
AU  - Alecu L
FAU - Barbulescu, M
AU  - Barbulescu M
FAU - Ursut, B
AU  - Ursut B
FAU - Enciu, O
AU  - Enciu O
FAU - Slavu, I
AU  - Slavu I
FAU - Braga, V
AU  - Braga V
LA  - eng
PT  - Journal Article
PL  - Romania
TA  - Chirurgia (Bucur)
JT  - Chirurgia (Bucharest, Romania : 1990)
JID - 9213031
RN  - Papillary Thyroid Microcarcinoma
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Carcinoma, Papillary/diagnosis/epidemiology/*surgery
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Neoplasms, Unknown Primary/diagnosis/epidemiology/*surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Romania/epidemiology
MH  - Thyroid Neoplasms/diagnosis/epidemiology/*surgery
MH  - *Thyroidectomy/methods
MH  - Treatment Outcome
EDAT- 2014/04/20 06:00
MHDA- 2014/07/26 06:00
CRDT- 2014/04/19 06:00
PHST- 2014/04/01 00:00 [accepted]
PHST- 2014/04/19 06:00 [entrez]
PHST- 2014/04/20 06:00 [pubmed]
PHST- 2014/07/26 06:00 [medline]
AID - 6 [pii]
PST - ppublish
SO  - Chirurgia (Bucur). 2014 Mar-Apr;109(2):191-7.