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Grani G, Cera G, Conzo G, Del Gatto V, di Gioia CRT, Maranghi M, Lucia P, Cantisani V, Metere A, Melcarne R, Borcea MC, Scorziello C, Menditto R, Summa M, Biffoni M, Durante C, Giacomelli L. Preoperative Ultrasonography in the Evaluation of Suspected Familial Non-Medullary Thyroid Cancer: Are We Able to Predict Multifocality and Extrathyroidal Extension? J Clin Med 2021; 10:jcm10225277. [PMID: 34830559 PMCID: PMC8624166 DOI: 10.3390/jcm10225277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
Family history of thyroid cancer increases the risk of harboring thyroid malignancies that end up having extrathyroidal extension (ETE) and multifocality on histology; some authors suggest a more aggressive surgical approach. Their pre-operative identification could allow more conservative surgical procedures if none of these features are suspected. Our aim was to assess if neck ultrasonography could identify or exclude multifocality or ETE in these patients to tailor the extent of surgery. This retrospective study included patients with previous thyroid surgery, ≥1 first-grade relative with thyroid cancer, and who had undergone pre-surgical ultrasound. ETE was suspected in the case of thyroid border interruption or gross invasion of perithyroidal tissues. Multiple suspicious nodules were defined as suspicion of multifocal cancer. The cohort consisted of 45 patients (median age 49 years, 40 with thyroid cancer, 30 females). The positive predictive value of ultrasonography in predicting multifocality and ETE was 57.14% (25.25–84.03) and 41.67% (21.5–65.1%), respectively, while the negative predictive values were 63.2% (56.4–69.4%) and 72.7% (63.3–80.5%). Pre-operative ultrasound examination is unable to reliably identify or exclude multifocal disease or extrathyroidal extension. In patients scheduled for surgery and with a first-degree relative affected by DTC, a “negative” pre-operative US report does not exclude the potential finding of multifocality and ETE at final histopathology.
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Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Gianluca Cera
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Giovanni Conzo
- Department of Cardiothoracic Sciences, University of Campania Luigi Vanvitelli, I-80131 Naples, Italy;
| | - Valeria Del Gatto
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Cira Rosaria Tiziana di Gioia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (C.R.T.d.G.); (V.C.)
| | - Marianna Maranghi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Piernatale Lucia
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Vito Cantisani
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (C.R.T.d.G.); (V.C.)
| | - Alessio Metere
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Rossella Melcarne
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Maria Carola Borcea
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Chiara Scorziello
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Rosa Menditto
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Marco Summa
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
- Correspondence: ; Tel.: +39-0-649-975-130
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
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