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Occult cancer after thyroidectomy for benign thyroid disorders. Is total thyroidectomy justified based on these grounds?

  • Prospective Surgical Study
  • Published:
Hellenic Journal of Surgery

Abstract

Background

It is well known that thyroid nodules are common among the general population. Despite the fact that only 4–8% are clinically detectable, a higher percentage ranging between 13–67% are identified with ultrasonography. Many studies have shown that malignancy can be detected in 5% of these nodules irrespective of their size. Nowadays, total thyroidectomy seems to be the most appropriate operation, even for benign thyroid diseases. We conducted this prospective study in order to assess the true incidence of occult thyroid cancer in benign thyroid disease specimens and explore any associated factors. Finally, we wanted to appraise whether total thyroidectomy is indeed justified based on these grounds.

Materials and methods

From March 2010 to March 2014, we operated on 114 patients for benign thyroid pathology; the patients had a mean age of 52.24 years (17–81 years). Thirty patients were eventually found to have occult cancer (19 microcarcinomas and 11 macrocarcinomas).We compared the patients with and without cancer in order to determine any predictive factors.

Results

Only the underlying histology was found to be related to the presence of cancer. Patients with cancer had a higher than expected percentage of Hashimoto thyroiditis while patients without cancer were found to have a greater than anticipated percentage of nodular hyperplasia. None of the other quantitative or qualitative factors were found to be a significant predictor of cancer.

Conclusion

After performing a proper workup as indicated by the guidelines, a high risk for occult thyroid cancer still remains (at least in the Greek population), which justifies the selection of total thyroidectomy for the management of benign thyroid pathologies. Only the underlying histology is associated with the presence of cancer since Hashimoto thyroiditis seems to be a risk factor.

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Authors and Affiliations

  1. 2nd Surgical Department and Surgical Oncology Unit, “Korgialenio–Benakio”, Red Cross Athens General Hospital, Athens, Greece

    Sophocles Lanitis, V. Ganis, G. Sgourakis, P. Brotzakis & C. Karaliotas

  2. Endocrinology department, “Korgialenio–Benakio”, Red Cross Athens General Hospital, Athens, Greece

    A. Bryonidou

Authors
  1. Sophocles Lanitis
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  2. V. Ganis
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  3. G. Sgourakis
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  4. P. Brotzakis
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  5. A. Bryonidou
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  6. C. Karaliotas
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Correspondence to Sophocles Lanitis.

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Lanitis, S., Ganis, V., Sgourakis, G. et al. Occult cancer after thyroidectomy for benign thyroid disorders. Is total thyroidectomy justified based on these grounds?. Hellenic J Surg 87, 309–316 (2015). https://doi.org/10.1007/s13126-015-0231-4

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  • DOI: https://doi.org/10.1007/s13126-015-0231-4

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