Abstract
Purpose: Our purpose is to detect the rate of incidental carcinoma in multinodulary goiter. However thyroid nodules' frequency is 4-7 % in normal population, malignant nodules are much rare. They represent only 0.2 % of deaths due to cancer. According to the investigations, malignant diseases of the thyroid gland is much more than detected values, but they are considered rare due to the slow and benign nature of the disease. İncidental carcinoma frequency after evaluation of specimens of multinodular thyroid disease changes between 3- 16 % differentiating from population to population.
Materials and Methods: In our study we evaluated 267 patients retrospectively and detected the incidental carcinoma ratio and evaluated treatment protocols.
Result: In our patient group we found out that with considering the complication risks in benign diseases we prefered bilateral near total thyroidectomy or total thyroidectomy as the operative technique.
Conclusion: Bilateral near total thyroidectomy or total thyroidectomy could be decided as the operative technique.
Keywords:
Multinodular goiter, incidental carcinoma, thyroid surgery
References
1Liebeskind A, Sikora AG, Komisar A, et al. Rates of malignancy in incidentally discovered thyroid nodules evaluated with sonography and fine-needle aspiration. J Ultrasound Med, 2005; 24: 629-634.
2Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med, 1997; 126: 226-231.
3Tuncel E, Ersoy C, Erturk E, et al. Retrospective analysis of the histopathological pattern of thyroid cancer in the southern Marmara region of Turkey and comparison of the data with the data previous decade. Turk JEM,1997; 1: 8-12.
4Cohen-Kerem R, Schachter P, Sheinfeld M, et al. Multinodular goiter: The surgical procedure of choice. Otolaryngol Head Neck Surg, 2000; 122: 848-850.
5Friguglietti CU, Lin CS, Kulcsar MA. Total thyroidectomy for benign thyroid disease. Laryngoscope, 2003; 113: 1820-1826.
6Bron LP, O'Brien CJ. Total thyroidectomy for clinically benign disease of the thyroid gland. Br J Surg, 2004; 91:569-574.
7Prades JM, Dumollard JM, Timoshenko A et al. Multinodular goiter: surgical management and histopathological findings. Eur Arch Otorhinolaryngol, 2002; 259: 217-221.
8Bondeson L, Lujenberg O. Occult thyroid carcinoma at autopsy in Malmo, Sweden. Cancer, 1981; 47: 319-323.
9Lin JD, Chen ST, Chao TC, et al. Diagnosis and therapeutic strategy for papillary thyroid microcarcinoma. Arch Surg, 2005; 140: 940-945.
10Carpi A, Nicolini A, Casara D,et al. Nonpalpable thyroid carcinoma, clinical controversies on preoperative selection. Am J Clin Oncol, 2003; 26: 232-235.
11Silver RJ, Parangi S. Management of thyroid incidentalomas. Surg Clin N Am, 2004; 84: 907-919.
12Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas: prevalence by palpation and ultrasonography. Arch Intern Med, 1994; 154: 1838-1840.
13Mitchell J, Parangi S. The thyroid incidentaloma: An increasingly frequent consequence of radiologic imaging. Semin Ultrasound CT MRI, 2005; 26: 37-46.
14Koh KBH, Chang KW. Carcinoma in multinodular goitre. Br J Surg, 1992; 79: 266-267.
15Pelizzo MR, Bernante P, Toniato A,et al. Frequency of thyroid carcinoma in a recent series of 539 consecutive thyroidectomies for multinodular goiter. Tumori, 1997; 83: 653-655.
16Miccoli P, Minuto MN, Galeri D, et al. Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. ANZ J Surg, 2006; 76: 123-126.
17Gandolfi PP, Frisina A, Raffa M, et al. The incidence of thyroid carcinoma in multinodular goiter: retrospective analysis. Acta Biomed Ateneo Parmense, 2004; 75: 114-117.
18Giles Y, Boztepe H, Terzioğlu T, et al. The advantage of total thyroidectomy to avoid reoperation for incidental thyroid cancer in multinoduler goiter. Arch Surg, 2004; 139: 179-182.
19Sakorafas GH, Giotakis J, Stafyla V. Papillary thyroid microcarcinoma: A surgical perspective. Cancer Treat Rev, 2005; 31: 423-438.
20Düren M, Bukey Y, Özyegin MA, et al. Impact of initial surgical treatment on survival of patients with differentiated thyroid cancer: experience of an endocrine surgery center in an iodine- deficient region. World J Surg, 2000; 24: 1290- 1294.
21Rodriguez JM, Moreno A, Parrilla P, et al. Papillary thyroid microcarcinoma: clinical study and prognosis. Eur J Surg, 1997; 163: 255-259.
22Sherman SI, editors. Thyroid Carcinoma. NCCN Clinical practice guidelines in Oncology, 2006. V2. 7-10.
23Pezzullo L, Delrio P, Losito NS, et al. Post-operative complications after completion thyroidectomy for differantiated thyroid cancer. Eur J Surg Oncol, 1997; 23: 215-218.