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Annals of Surgical Oncology

, Volume 11, Issue 1, pp 94–98 | Cite as

The utility of frozen section evaluation for follicular thyroid lesions

  • Rachael A. Callcut
  • Suzanne M. Selvaggi
  • Eberhard Mack
  • Omer Ozgul
  • Thomas Warner
  • Herbert Chen
Original Articles

Abstract

Background

Because fine-needle aspiration cannot reliably discriminate between benign and malignant follicular thyroid lesions, some surgeons use intraoperative frozen section (FS) to guide operative management. To determine the utility of FS for these lesions, we reviewed our institutional experience.

Methods

Between 1994 and 2001, 152 patients underwent surgical resection for follicular neoplasms.

Results

The mean age of the patients was 47 years, and 76% were female. Forty-one (32%) FSs were reported as benign, 5 (4%) as malignant, and 3 (2%) as indeterminate, and in 80 (62%), the diagnosis was “follicular lesion, deferred to permanent histology.” On paraffin section, all patients with malignant FSs had thyroid cancer, and all 41 patients with benign FSs had benign lesions. Thus, FS for diagnosis of follicular thyroid cancer had a sensitivity, specificity, positive predictive value, and accuracy of 67%, 100%, 100%, and 96%, respectively. In most cases (64%), FS rendered no additional information at the time of operation. Therefore, the cost per useful FS was $7800, which is higher than the charge of a completion thyroidectomy (approximately $6000).

Conclusions

FS analysis for follicular lesions seems to be highly specific and accurate. However, because of the low sensitivity, routine use of FS is not cost-effective in patients with follicular thyroid lesions.

Key words

Frezen section Follicular thyroid lesions Fine-needle aspiration Thyroidectomy 

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Copyright information

© The Society of Surgical Oncology, Inc 2003

Authors and Affiliations

  • Rachael A. Callcut
    • 1
  • Suzanne M. Selvaggi
    • 2
  • Eberhard Mack
    • 1
  • Omer Ozgul
    • 1
  • Thomas Warner
    • 2
  • Herbert Chen
    • 1
  1. 1.Department of SurgeryUniversity of Wisconsin H4/750 Clinical Science CenterMadison
  2. 2.Department of Pathology and Laboratory MedicineUniversity of Wisconsin, H4/750 Clinical Science CenterMadison

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