World Journal of Surgery

, Volume 38, Issue 3, pp 704–708 | Cite as

Optimal Timing of Surgery for Differentiated Thyroid Cancer in Pregnant Women

  • Takashi Uruno
  • Hiroshi Shibuya
  • Wataru Kitagawa
  • Mitsuji Nagahama
  • Kiminori Sugino
  • Koichi Ito



Differentiated thyroid cancer (DTC) is the second most common cancer diagnosed in pregnant women, but there is no consensus as to whether surgery should be performed during pregnancy or after delivery.


We retrospectively reviewed the records of 45 patients with DTC operated on during pregnancy or within 1 year after delivery, and we compared the clinicopathological features and outcomes of the patients operated during pregnancy (group A, n = 24) and the patients operated after delivery (group B, n = 21).


All 45 patients were histologically diagnosed with well-differentiated papillary thyroid cancer. Nineteen (79 %) of the 24 patients in group A underwent thyroidectomy during the second trimester. No complications associated with surgery or general anesthesia were reported in either group. There were no significant differences between the two groups in terms of age, tumor size, incidence of lymph node metastasis, or incidence of extrathyroidal extension. No distant metastases were detected in any of the patients. Two small for date infants (8.3 %) and 2 heavy for date infants (8.3 %) were delivered in group A, but only 1 small for date infant (4.7 %) was delivered in group B. There were no miscarriages, and none of the infants in either group had birth defects. Because 3 patients in group A and 1 patient in group B experienced a local recurrence, salvage surgeries were performed.


Although thyroid surgery was performed safely in the second trimester, surgery after delivery was also acceptable. Surgery after delivery is recommended for most patients with non-aggressive DTC.


Thyroid Cancer Thyroid Surgery Differentiate Thyroid Cancer Extrathyroidal Extension Receive Thyroid Stimulate Hormone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Cooper DS, Doherty GM, Haugen BR et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214PubMedCrossRefGoogle Scholar
  2. 2.
    Stagnaro-Green A, Abalovich M, Alexander E et al (2011) Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 21:1081–1125PubMedCrossRefGoogle Scholar
  3. 3.
    Kuy S, Roman SA, Desai R et al (2009) Outcomes following thyroid and parathyroid surgery in pregnant women. Arch Surg 144:399–406 discussion 406PubMedCrossRefGoogle Scholar
  4. 4.
    Herzon FS, Morris DM, Segal MN et al (1994) Coexistent thyroid cancer and pregnancy. Arch Otolaryngol Head Neck Surg 120:1191–1193PubMedCrossRefGoogle Scholar
  5. 5.
    Moosa M, Mazzaferri EL (1997) Outcome of differentiated thyroid cancer diagnosed in pregnant women. J Clin Endocrinol Metab 82:2862–2866PubMedCrossRefGoogle Scholar
  6. 6.
    Abalovich M, Amino N, Barbour LA et al (2007) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 92:S1–S47PubMedCrossRefGoogle Scholar
  7. 7.
    Choe W, McDougall IR (1994) Thyroid cancer in pregnant women: diagnostic and therapeutic management. Thyroid 4:433–435PubMedCrossRefGoogle Scholar
  8. 8.
    Rosen IB, Korman M, Walfish PG (1997) Thyroid nodular disease in pregnancy: current diagnosis and management. Clin Obstet Gynecol 40:81–89PubMedCrossRefGoogle Scholar
  9. 9.
    Doherty CM, Shindo ML, Rice DH et al (1995) Management of thyroid nodules during pregnancy. Laryngoscope 105:251–255PubMedCrossRefGoogle Scholar
  10. 10.
    Schlumberger M, De Vathaire F, Ceccarelli C et al (1995) Outcome of pregnancy in women with thyroid carcinoma. J Endocrinol Invest 18:150–151PubMedGoogle Scholar
  11. 11.
    Vini L, Hyer S, Pratt B et al (1999) Management of differentiated thyroid cancer diagnosed during pregnancy. Eur J Endocrinol 140:404–406PubMedCrossRefGoogle Scholar
  12. 12.
    Yasmeen S, Cress R, Romano PS et al (2005) Thyroid cancer in pregnancy. Int J Gynaecol Obstet 91:15–20PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Takashi Uruno
    • 1
  • Hiroshi Shibuya
    • 1
  • Wataru Kitagawa
    • 1
  • Mitsuji Nagahama
    • 1
  • Kiminori Sugino
    • 1
  • Koichi Ito
    • 1
  1. 1.Department of SurgeryIto HospitalTokyoJapan

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