THE RISK OF MICROCARCINOMA IN PATIENTS WITH MULTINODULAR GOITER

Abstract

The aim of this study is to evaluate the frequency of microcarcinoma in multinodular goiter cases operated in the Department of General Surgery, Kocaeli School of Medicine. Microcarcinoma of the thyroid has been reported to be found as much as 22% of autopsy series and 24% of thyroidectomy samples with the preoperative diagnosis of benign diseases. Recently, authors recommend identical therapeutic approach for both micro and frank carcinomas because of the similar frequencies of local and distant metastasis and recurrence in both situations. There were nine cases (3.1 %) of papillary microcarcinoma within totally 288 operated patients with multinodular goiter. Bilateral subtotal thyroidectomy was performed in five cases, lobectomy plus subtotal lobectomy in four cases. A case with three different foci and one case at the age of 51 years who had bilateral subtotal thyroidectomy in the initial operation were reoperated for completion thyroidectomy. There was not any residual tumor or any other focus in the resected tissues of these cases. A patient with two foci of carcinoma denied the second operation. As a result, it can be said that microcarcinoma is found in considerable percent of patients with multinodular goiter. When the surgeon has confronted with this situation, he/she must evaluate the patient about the risk factors and perform completion thyroidectomy when needed.