Follicular Neoplasms of the Thyroid: Predictors of Malignancy?

American Surgeon - Tập 67 Số 9 - Trang 880-884 - 2001
Michael J. Zdon1, Allan J. Fredland1, Phillip H. Zaret1
1Department of Surgery, Finch University of Health Sciences/The Chicago Medical School at Mount Sinai Hospital Medical Center and Highland Park Hospital, Chicago and Highland Park, Illinois

Tóm tắt

Follicular neoplasms of the thyroid present a therapeutic challenge. Initial limited thyroidectomy may result in some patients requiring completion thyroidectomy for malignancy. In the current study we examined age, gender, race, time from nodule discovery to operation in months, history of radiation exposure, tumor size (cm), and cell type in patients with follicular neoplasms identified at the time of thyroidectomy in two socioeconomically diverse settings from 1993 through 2000 to identify possible factors associated with a greater chance of malignancy. Of 36 follicular lesions identified in 35 patients seven (19%) were malignant on permanent section. Hurthle cell histology was present in six of 36 lesions. Mean age of patients with benign lesions was 47 ± 13 versus 50 ± 15 in malignant cases ( P > 0.05). Benign lesions measured 2.6 ± 1.2 cm versus 3.1 ± 1.7 cm in malignant ( P > 0.05). Other factors found not to be significant included gender and time nodule was present (12.8 ± 19 months benign vs 11.8 ± 20 months malignant) ( P > 0.05). Hurthle cell histology was associated with a 50 per cent malignancy rate (three of six) versus 13 per cent (four of 30) with non-Hurthle cell histology ( P < 0.05). Two patients with exposure to radiation fallout had malignancies in lesions of one and 2 cm ( P < 0.05). Patients from a socioeconomically disadvantaged setting had a malignancy rate of 50 per cent (six of 12) compared with a malignancy rate of 3 per cent (one of 24) from a socioeconomically affluent population ( P < 0.05). In conclusion Hurthle cell histology and exposure to radiation fallout were associated with significantly higher rates of malignancy in follicular neoplasms and should be taken into account when deciding on the initial extent of thyroidectomy. The difference in malignancy rates observed between socioeconomic settings while significant requires further investigation.

Từ khóa


Tài liệu tham khảo

10.1016/S0039-6060(99)70138-8

Shaha AR, 1990, Surgery, 108, 964

10.1016/S0002-9610(96)00302-9

10.1002/1097-0142(19910701)68:1<130::AID-CNCR2820680124>3.0.CO;2-9

10.1097/00000658-199507000-00016

10.1001/archotol.1986.03780110083013

10.1067/msy.2000.109962

10.1016/0002-9610(91)90901-O

10.1016/0002-9343(92)90164-7

10.1002/1097-0142(19911101)68:9<1944::AID-CNCR2820680917>3.0.CO;2-I

10.1089/thy.1998.8.377

10.1097/00000658-199804000-00015

10.1111/j.1445-2197.1993.tb00467.x

Hempelman LH., 1968, Science, 160, 159, 10.1126/science.160.3824.159

10.1016/0002-9343(83)91077-X

10.1016/S0039-6109(16)40846-7

10.1038/359021b0

10.1002/1097-0142(19940715)74:2<748::AID-CNCR2820740231>3.0.CO;2-H

10.1002/(SICI)1097-0142(19990701)86:1<149::AID-CNCR21>3.0.CO;2-A

10.1097/00000658-198112000-00002

10.1210/jcem-11-12-1535

Gardner LW., 1955, Arch Pathol Lab Med, 59, 372

10.1002/1097-0142(19860415)57:8<1613::AID-CNCR2820570829>3.0.CO;2-3

10.1001/jama.1984.03340470040023

10.1001/archsurg.1984.01390170015004

Arganini M, 1986, Surgery, 100, 1108

Thompson NW, 1974, Surg Gynecol Obstet, 139, 555

10.1016/S0039-6060(05)80039-X

10.1097/00000658-199804000-00015

Spitz, 1981, Cancer, 42, 549

10.1002/jso.2930490407

Thông tin
Thông tin xuất bản

American Surgeon

Tập 67 Số 9

880-884

Thông tin tác giả