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Courtade-Saïdi M, Uro-Coste E, Vergez S, Verillaud B, Pham Dang N, Chabrillac E, Fakhry N, Bigorgne C, Costes-Martineau V. Cytopathological analysis of salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:87-91. [PMID: 38052703 DOI: 10.1016/j.anorl.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To determine the indications for fine-needle cytology and the modalities of frozen section pathological analysis in the management of salivary gland cancer. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method. RESULTS Fine-needle cytology is recommended as part of the diagnostic work-up for a major salivary gland tumor suspicious for malignancy. Fine-needle cytology should be performed after MRI to avoid artifacts. Frozen section analysis is recommended to confirm the malignant nature of the tumor, to adapt the extent of resection and to indicate neck dissection. Whenever possible, the entire tumor and adjacent salivary or periglandular tissue should be sent for frozen section analysis. CONCLUSION Fine-needle cytology and frozen section analysis play an essential role in the management of salivary gland cancers.
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Affiliation(s)
- M Courtade-Saïdi
- Département d'anatomie et de cytologie pathologiques, faculté de santé, institut universitaire du cancer Toulouse - Oncopole, université Toulouse III Paul-Sabatier, Toulouse, France
| | - E Uro-Coste
- Département d'anatomie et de cytologie pathologiques, faculté de santé, institut universitaire du cancer Toulouse - Oncopole, université Toulouse III Paul-Sabatier, Toulouse, France
| | - S Vergez
- Département de chirurgie ORL et cervicofaciale, université Toulouse III Paul-Sabatier, CHU de Toulouse-Larrey, Toulouse, France; Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France.
| | - B Verillaud
- Inserm U1141, département d'ORL et de chirurgie cervicofaciale, hôpital Lariboisière, université Paris-Cité, AP-HP, Paris, France
| | - N Pham Dang
- Inserm, Neuro-Dol, service de chirurgie maxillofaciale, université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France
| | - N Fakhry
- Département d'ORL et chirurgie cervicofaciale, hôpital La Conception, Aix-Marseille université, AP-HM, Marseille, France
| | - C Bigorgne
- Centre de pathologie et d'imagerie, Paris, France
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Tummidi S, Sathe P, Gholap P, Patil M, Kothari K. Scar site metastasis of renal cell carcinoma diagnosed on-site cytology: a case report. BMC Cancer 2018. [PMID: 29514606 PMCID: PMC5842603 DOI: 10.1186/s12885-018-4167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Renal cell carcinomas (RCCs) have a propensity for widespread metastases and a wide range of survival rates. They can spread into adjacent organs by direct extension and can invade local or distant sites by lymphatic, hematogenous or lympho-hematogeneous pathways. Scar site metastasis is very rare. CASE PRESENTATION We report a rare case of scar site RCC metastasis in a patient who underwent left radical nephrectomy 10 months ago. CONCLUSION FNAC is a simple and easy technique that can help in the definitive diagnosis of subcutaneous lesions. A correct early stage diagnosis of metastatic RCC can considerably improve the survival rates.
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Affiliation(s)
- Santosh Tummidi
- Department of Pathology, Seth GSMC & KEMH, Parel, Mumbai, 400012, Maharashtra, India.
| | - Pragati Sathe
- Department of Pathology, Seth GSMC & KEMH, Parel, Mumbai, 400012, Maharashtra, India
| | - Prachi Gholap
- Department of Pathology, Seth GSMC & KEMH, Parel, Mumbai, 400012, Maharashtra, India
| | - Manoj Patil
- Department of Pathology, Seth GSMC & KEMH, Parel, Mumbai, 400012, Maharashtra, India
| | - Kanchan Kothari
- Department of Pathology, Seth GSMC & KEMH, Parel, Mumbai, 400012, Maharashtra, India
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3
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Medas F, Erdas E, Gordini L, Conzo G, Gambardella C, Canu GL, Pisano G, Nicolosi A, Calò PG. Risk of malignancy in thyroid nodules classified as TIR-3A: What therapy? Int J Surg 2018; 41 Suppl 1:S60-S64. [PMID: 28506415 DOI: 10.1016/j.ijsu.2017.03.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/20/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of the present study was to assess the clinical applicability of the TIR3A category in managing thyroid nodules, to examine the malignancy rates of TIR 3A and TIR 3B nodules, and to suggest management guidelines for these nodules. MATERIALS AND METHODS Thyroid cytologies performed in patients referred to our Department between January 2014 and August 2016 were classified according to the guidelines published by the SIAPEC. 102 cases were included in this retrospective study and were divided into two groups: 19 TIR3A were included in group A and 83 TIR3B in group B. RESULTS In group A, malignancy was diagnosed in 4 (21.1%) cases, papillary thyroid cancer was found in 3 patients and follicular thyroid cancer in 1; one case was classified as microcarcinoma, in two cancer was multicentric and bilateral and in one central node metastases were observed. In Group B malignancy was diagnosed in 48 (57.8%) patients, papillary thyroid cancer was found in 36 patients and follicular cancer in 12; microcarcinoma was observed in 25 cases, 12 were unilateral multicentric and 7 bilateral multicentric; in 3 cases central node metastases were present. CONCLUSION Thyroid nodules with TIR3A cytology have a lower risk of malignancy than TIR3B cases, for which the new SIAPEC classification has proved accurate and effective. Malignancy rates in nodules with TIR3A cytology are higher than expected, although the real and accurate definition of the risk is extremely difficult. The recommendation to perform an accurate follow-up and repeat the fine-needle aspiration still appears the best option. For better management of patients with TIR3A cytology a careful assessment of risk factors and ultrasound characteristics is always needed. Further multicenter studies with longer follow-up are needed to better define the efficacy of this classification, the actual cancer risk, and the best management of these lesions.
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Affiliation(s)
- Fabio Medas
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Enrico Erdas
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Luca Gordini
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Giovanni Conzo
- Università degli Studi della Campania "Luigi Vanvitelli" - School of Medicine, Division of General Surgery and Surgical Oncology, Via Gen.G.Orsini 42, 80132 Naples, Italy.
| | - Claudio Gambardella
- Università degli Studi della Campania "Luigi Vanvitelli" - School of Medicine, Division of General Surgery and Surgical Oncology, Via Gen.G.Orsini 42, 80132 Naples, Italy.
| | - Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Giuseppe Pisano
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Angelo Nicolosi
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato, CA, Italy.
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Cipolletta Campanile A, Malzone MG, Losito NS, Botti G, Chiofalo MG, Faggiano A, Siciliano R, Colao A, Pezzullo L, Fulciniti F. Accuracy of Fine Needle Cytology in Histological Prediction of Papillary Thyroid Carcinoma Variants: a Prospective Study. Endocr Pathol 2017. [PMID: 28639242 DOI: 10.1007/s12022-017-9488-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Fine needle cytology (FNC) is a crucial procedure in the preoperative diagnosis of thyroid tumors. Papillary thyroid carcinoma (PTC), in its classic variant (cPTC), is the most common malignant neoplasm of the thyroid. Several histological variants of PTC have been described, each one with its own characteristics and prognosis. The ability of FNC to identify the variants represents a challenge even for a skilled pathologist. The aim of this study was to evaluate the diagnostic cytological accuracy of FNC in PTC and to look for specific features that could predict the different variants. This was a single center prospective study on 128 patients who received a diagnosis of PTC on FNC. The smears were blindly reviewed by two cytopathologists to create a frequency score (0, 1, 2, 3) of the features for each variant. The cytological parameters were divided into three groups: architectural, nucleo-cytoplasmic, and background features. Univariate analysis was performed by chi-square test with Yates correction and Fisher exact test as appropriate. Multiple regression analysis was performed among the variables correlated at the linear correlation. The correlation study between cytology and histology showed an accuracy of FNC in classic, follicular, and oncocytic PTC variants of 63.5, 87.5, and 87% respectively. Familiarity with cytological features may allow an early diagnosis of a given PTC variant on FNC samples. This is fundamental in a preoperative evaluation for the best surgical approach and subsequent treatment.
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Affiliation(s)
- Anna Cipolletta Campanile
- Pathology and Cytopathology Unit, National Cancer Institute "Fondazione G. Pascale", via Mariano Semmola, 80131, Naples, Italy
| | - Maria Gabriella Malzone
- Pathology and Cytopathology Unit, National Cancer Institute "Fondazione G. Pascale", via Mariano Semmola, 80131, Naples, Italy.
| | - Nunzia Simona Losito
- Pathology and Cytopathology Unit, National Cancer Institute "Fondazione G. Pascale", via Mariano Semmola, 80131, Naples, Italy
| | - Gerardo Botti
- Pathology and Cytopathology Unit, National Cancer Institute "Fondazione G. Pascale", via Mariano Semmola, 80131, Naples, Italy
| | - Maria Grazia Chiofalo
- Thyroid Surgery Unit, National Cancer Institute "Fondazione G. Pascale", Naples, Italy
| | - Antongiulio Faggiano
- Thyroid Surgery Unit, National Cancer Institute "Fondazione G. Pascale", Naples, Italy
| | - Roberta Siciliano
- Department of Industrial Engineering, University of Naples "Federico II", via Claudio - 21, 80131, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", via Pansini - 5, 80131, Naples, Italy
| | - Luciano Pezzullo
- Thyroid Surgery Unit, National Cancer Institute "Fondazione G. Pascale", Naples, Italy
| | - Franco Fulciniti
- Clinical Cytopathology Service, Institute of Pathology, via A. Franzoni - 45, 6601, Locarno, Switzerland
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Conzo G, Avenia N, Ansaldo GL, Calò P, De Palma M, Dobrinja C, Docimo G, Gambardella C, Grasso M, Lombardi CP, Pelizzo MR, Pezzolla A, Pezzullo L, Piccoli M, Rosato L, Siciliano G, Spiezia S, Tartaglia E, Tartaglia F, Testini M, Troncone G, Signoriello G. Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series. Endocrine 2017; 55:530-538. [PMID: 27075721 DOI: 10.1007/s12020-016-0953-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/05/2016] [Indexed: 02/06/2023]
Abstract
The most appropriate surgical management of "follicular neoplasm/suspicious for follicular neoplasm" lesions (FN), considering their low definitive malignancy rate and the limited predictive power of preoperative clinic-diagnostic factors, is still controversial. On behalf of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB), we collected and analyzed the experience of 26 endocrine centers by computerized questionnaire. 1379 patients, surgically treated after a FN diagnosis from January 2012 and December 2103, were evaluated. Histological features, surgical complications, and medium-term outcomes were reported. Total thyroidectomy (TT) was performed in 1055/1379 patients (76.5 %), while hemithyroidectomy (HT) was carried out in 324/1379 cases (23.5 %). Malignancy rate was higher in TT than in HT groups (36.4 vs. 26.2 %), whereas the rates of transient and definitive hypoparathyroidism following TT were higher than after HT. Consensual thyroiditis (16.8 vs. 9.9 %) and patient age (50.9 vs. 47.9 %) also differed between groups. A cytological FN diagnosis was associated to a not negligible malignancy rate (469/1379 patients; 34 %), that was higher in TT than in HT groups. However, a lower morbidity rate was observed in HT, which should be considered the standard of care in solitary lesions in absence of specific risk factors. Malignancy could not be preoperatively assessed and clinical decision-making is still controversial. Further efforts should be spent to more accurately preoperatively classify FN thyroid nodules.
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Affiliation(s)
- Giovanni Conzo
- Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, Second University of Naples, Via Gen.G.Orsini 42, 80132, Naples, Italy.
| | - Nicola Avenia
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
- Unit of Endocrine Surgery, S. Maria University Hospital, Terni, Italy
| | - Gian Luca Ansaldo
- Dipartimento di Discipline Chirurgiche, Morfologiche e Metodologie Integrate, Cattedra di Chirurgia Generale, Università degli Studi di Genova, Genoa, Italy
| | - Piergiorgio Calò
- Chirurgia Generale A, Policlinico Universitario di Monserrato, AOU di Cagliari, Monserrato, Italy
| | - Maurizio De Palma
- General Surgery and Endocrine Surgical Unit, AORN A. Cardarelli, Naples, Italy
| | - Chiara Dobrinja
- UCO Chirurgia Generale, Cattinara Teaching Hospital, Strada di Fiume, 34100, Trieste, Italy
| | - Giovanni Docimo
- Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, Second University of Naples, Via Gen.G.Orsini 42, 80132, Naples, Italy
| | - Claudio Gambardella
- Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, Second University of Naples, Via Gen.G.Orsini 42, 80132, Naples, Italy
| | - Marica Grasso
- General Surgery and Endocrine Surgical Unit, AORN A. Cardarelli, Naples, Italy
| | - Celestino Pio Lombardi
- Division of Endocrine and Metabolic Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Rosa Pelizzo
- Clinica Chirurgica 2, University School of Padova, Padova University, Padua, Italy
| | - Angela Pezzolla
- Department of Emergency and Oral Transplantation-DETO, Bari University Hospital Policlinico, Bari, Italy
| | - Luciano Pezzullo
- Thyroid and Parathyroid Surgery Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Via Mariano Semmola, Naples, Italy
| | - Micaela Piccoli
- Chirurgia Generale d'Urgenza e Nuove Tecnologie - NOCSAE di Modena, Modena, Italy
| | | | - Giuseppe Siciliano
- Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, Second University of Naples, Via Gen.G.Orsini 42, 80132, Naples, Italy
| | - Stefano Spiezia
- Ultrasound Guided and Neck Pathologies Surgery Operative Unit, Department of Surgery, S. Maria del Popolo degli Incurabili ASLNA1 Hospital, Naples, Italy
| | - Ernesto Tartaglia
- Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, Second University of Naples, Via Gen.G.Orsini 42, 80132, Naples, Italy
| | | | - Mario Testini
- Unit of Endocrine, Digestive, and Emergency Surgery, Department of Biomedical Sciences and Human Oncology, Bari, Italy
| | - Giancarlo Troncone
- Department of Biomorphologic and Functional Sciences, "Federico II" University of Naples, Naples, Italy
| | - Giuseppe Signoriello
- Department of Mental Health and Preventive Medicine, Second University of Naples, Caserta, Italy
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Cortese A, Pantaleo G, Ferrara I, Vatrella A, Cozzolino I, Di Crescenzo V, Amato M. Bone and soft tissue non-Hodgkin lymphoma of the maxillofacial area: report of two cases, literature review and new therapeutic strategies. Int J Surg 2014; 12 Suppl 2:S23-S28. [PMID: 25159545 DOI: 10.1016/j.ijsu.2014.08.388] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/15/2014] [Indexed: 12/14/2022]
Abstract
Primary mandibular non-Hodgkin lymphoma (NHL) and soft tissues NHL of the maxillofacial are extremely rare representing a minimal percentage of the head and neck tumors. Two cases of bone and soft tissue maxillofacial NHL are reported. Clinical, radiological and pathological features are described and the therapeutic procedures are discussed accordingly. Mandibular radiologic features have been carefully analyzed and discussed to achieve an early and accurate diagnosis avoiding improper dental therapies.
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Affiliation(s)
- Antonio Cortese
- Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy.
| | - Giuseppe Pantaleo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy.
| | - IdaLucia Ferrara
- Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy.
| | - Alessandro Vatrella
- Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy.
| | | | - Vincenzo Di Crescenzo
- Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy.
| | - Massimo Amato
- Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy.
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7
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Accurso A, Della Corte GA, Rocco N, Varone V, Buonaiuto R, Compagna R, Tari DU, Amato B, Riccardi A. Unusual breast lesion mimicking cancer: diabetic mastopathy. Int J Surg 2014; 12 Suppl 1:S79-82. [PMID: 24862664 DOI: 10.1016/j.ijsu.2014.05.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/03/2014] [Indexed: 01/25/2023]
Abstract
Diabetic mastopathy represents an uncommon tumor-like proliferation of fibrous tissue of the breast that usually occurs in patients who suffered from type 1 diabetes mellitus for a long time. We report an uncommon case of diabetic mastopathy presenting in a type 2 non-insulin dependent diabetes mellitus 61-year-old postmenopausal woman. Physical examination revealed a hard, low movable mass in the upper outer quadrant of the right breast. Mammography and ultrasonography showed typical features of breast cancer. Ultrasound-guided fine-needle aspiration cytology (US-FNAC) was performed showing inflammatory infiltrate, suggesting excisional biopsy. Histological findings demonstrated typical diabetic mastopathy with fibrosis, histiocytic and limphocytic infiltration without evidence of malignancy.
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Affiliation(s)
- Antonello Accurso
- Department of Gastroenterology, Endocrinology and Surgery, University Federico II of Naples, Naples, Italy
| | | | - Nicola Rocco
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via R. Galeazzi 4, 20161 Milan, Italy.
| | - Valeria Varone
- Department of Advanced Biomedical Sciences - Section of Pathology, University Federico II of Naples, Italy
| | - Riccardo Buonaiuto
- Department of Advanced Biomedical Sciences - Section of Imaging, University Federico II of Naples, Italy
| | - Rita Compagna
- Department of Gastroenterology, Endocrinology and Surgery, University Federico II of Naples, Naples, Italy
| | - Daniele Ugo Tari
- Department of Advanced Biomedical Sciences - Section of Imaging, University Federico II of Naples, Italy
| | - Bruno Amato
- Department of Gastroenterology, Endocrinology and Surgery, University Federico II of Naples, Naples, Italy
| | - Albina Riccardi
- Department of Advanced Biomedical Sciences - Section of Imaging, University Federico II of Naples, Italy
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8
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Conzo G, Calò PG, Gambardella C, Tartaglia E, Mauriello C, Della Pietra C, Medas F, Santa Cruz R, Podda F, Santini L, Troncone G. Controversies in the surgical management of thyroid follicular neoplasms. Retrospective analysis of 721 patients. Int J Surg 2014; 12 Suppl 1:S29-34. [PMID: 24859409 DOI: 10.1016/j.ijsu.2014.05.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/03/2014] [Indexed: 11/17/2022]
Abstract
The most appropriate surgical management of "follicular neoplasm/suspicious for follicular neoplasm" lesions, is still controversial. Analysing and comparing the experience of two units for endocrine surgery, we retrospectively evaluated 721 patients, surgically treated after a follicular neoplasm diagnosis. Total thyroidectomy was routinely performed in one Institution, while in the other one it was selectively carried out. The main criteria leading to hemythyroidectomy were a single nodule, the age ≤45 years, the absence of thyroiditis or clinical/intraoperative suspicion of malignancy. Total thyroidectomy was performed in 402/721 patients (55.7%), hemythyroidectomy in 319/721 cases (44.2%) and a completion thyroidectomy in 51/319 cases (15.9%). The overall malignancy rate was 24% (176/721 patients), respectively 16% (51/319 patients) following hemythyroidectomy, and 31% (125/402 patients) following total thyroidectomy. Definitive recurrent laryngeal nerve paralysis and permanent hypoparathyroidism were not reported in hemythyroidectomy patients in which lower mean hospitalization and costs were observed. Considering the low-risk of follicular neoplasm solitary lesions, hemythyroidectomy is still the safest standard of care with lower hospitalization and costs. In case of multiglandular disease or thyroiditis, that might be associated with a higher risk of cancer, total thyroidectomy should be recommended. Further investigation is warranted to achieve a better preoperative follicular neoplasm diagnostic accuracy in order to reduce the amount of unnecessary surgical operations with a diagnostic aim.
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Affiliation(s)
- Giovanni Conzo
- Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy.
| | | | - Claudio Gambardella
- Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy
| | - Ernesto Tartaglia
- Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy
| | - Claudio Mauriello
- Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy
| | - Cristina Della Pietra
- Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy
| | - Fabio Medas
- Department of Surgical Sciences University of Cagliari, Italy
| | - Rosa Santa Cruz
- Department of Surgical Sciences University of Cagliari, Italy
| | - Francesco Podda
- Department of Surgical Sciences University of Cagliari, Italy
| | - Luigi Santini
- Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy
| | - Giancarlo Troncone
- Department of Biomorphologic and Functional Sciences, "Federico II" University of Naples, Italy
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