Correlation between cytological and histological findings in patients who underwent thyroidectomy. Predictive value and confounders

Diet as a possible influencing factor in thyroid cancer incidence: the point of view of the nutritionist

The incidence of differentiated thyroid cancer has increased in the last decades all over the world. Different environmental factors are possible perpetrators of this exponential growth. Nutritional factors are among the main environmental factors studied for thyroid cancer in recent years. This review aims to overview the main dietary factors involved in thyroid cancer risk, providing specific nutrition recommendations from the endocrinological Nutritionist point of view. Among the single food, fish and shellfish are the primary natural source of iodine, selenium and vitamin D in the human diet. These nutrients are essential for the synthesis of thyroid hormones; however, their consumption is not consistently related to thyroid cancer risk. The high intake of fruit and vegetables, probably due to their vitamin and antioxidant content, shows a weak inverse association with thyroid cancer risk. Alcohol, meat, or other food groups/nutrients showed no significant effect on thyroid cancer. In conclusion, to date, no definite association among dietary factors, specific dietary patterns, and thyroid cancer, and its clinical severity and aggressiveness have been found. However, it is essential to underline that in the future, prospective studies should be carried out to precisely evaluate the qualitative and quantitative intake of nutrients by patients to establish with more confidence a potential correlation between food intake and the occurrence and development of thyroid cancer.

Is hemithyroidectomy sufficient in unilateral benign nodular goitre?

BACKGROUND

Multinodular goiter is a common disease. If only one thyroid lobe is affected, hemithyroidectomy may be preferred to reduce complication and hormone replacement therapy. However, completion thyroidectomy may be required later. The aim of the study was to evaluate the role of completion thyroidectomy in patients who develop nodules after hemithyroidectomy, and we aimed to find the ratio of patients who required hormone replacement for permanent hypothyroidism.

METHODS

Patients who underwent hemithyroidectomy for benign nodular goitre between January 2012 and June 2017 were analyzed. The age of the patients, gender, number of nodules and dimension of the largest nodule, preoperative fine needle aspiration biopsy results, and postoperative histopathology findings were recorded. The need for completion thyroidectomy and need for postoperative L-thyroxine treatment were based on these parameters.

RESULTS

A total of 170 patients were included in the study. During the follow-up period new nodule or progression in existing nodule was observed in 23% (39 patients) of the cases. Permanent hypothyroidism requiring L-thyroxine treatment was observed in 31% (53 patients) of the cases. In this study, young age, multiple nodules and toxic nodular goitre diagnosis were noted to be independent risk factors that contributed to progression diseases in cases operated for benign nodular goitre.

CONCLUSIONS

Due to low reoperation risk and acceptable permanent hypothyroidism rates, hemithyroidectomy is a viable option for benign goitre cases. The patients should be on follow-up for possible complications, especially hypothyroidism, for at least a year.