Incidental thyroid carcinoma (ITC): a retrospective study in a series of 737 patients treated for benign disease

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COD: 06_2010_421-428 Categorie: ,

Roberta Gelmini, Chiara Franzoni, Erica Pavesi, Francesca Cabry, Massimo Saviano

Ann. Ital. Chir., 2010 81: 421-427

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AIM: Aim of the study is to evaluate correlations between incidental thyroid carcinoma (ITC) and benign thyroid pathologies
(BTP), to determine the most represented histotype and to point out the total thyroidectomy’s possible advantages in
terms of radicality, follow-up management and incidence of complications.
MATERIALS AND METHODS: During 10 years, 739 patients underwent thyroid surgery for BTP. Fine needle biopsy (FNAB)
was negative in all cases; 503 total thyroidectomies(TT), 5 subtotal thyroidectomies(ST) and 231 emithyroidectomies(ET)
were performed.
RESULTS: The specimens pathological examination revealed the presence of a ITC in 82 patients (11.1%); the prevalent
histotype was the papillary one with a less than 1cm diameter in almost the totality of cases but with nodes metastasis
in the 3.6% of cases. Complications were detected in 117 patients with a morbidity rate of 15.8%.
DISCUSSION: In our study the ITC prevalence was of 11.1% similar to literature with a higher incidence in patients
affected by multinodular than uninodular goiter. No statistical significant differences were found between euthyroid and
toxic pathologies. In our series hyperthyroidism doesn’t seem to hold a protective role towards the ITC onset.
CONCLUSIONS: The ITC incidence is relevant; the prevalent histotype is papillary and nodes metastasis are present even
if in a low percentage of cases. Besides, the complications of TT are similar to conservative procedures. The recurrence
of goiter and ITC require a second surgical procedure, with a higher risk of complications. So we can claim that the
standard surgical treatment of bilateral PBT would be represented by TT.

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