No abstract

Pathohistologic studies were carried out for 186 nodules in 171 cases of thyroid cancer treated in the surgical clinic during the last 14 years. No definite relationship was found between the intraglandular dissemination and the size of cancer nodules. In the relationship between the intraglandular dissemination and histologic type of cancer, frequency of the intraglandular dissemination is definitely low in papillary adenocarcinoma. In the relationship between the intraglandular dissemination and the degree of histologic extension, advance in extension is accompanied by the increasing of the frequency of the intraglandular dissemination. In the cases with positive lymph node metastasis, the frequency of the intraglandular dissemination was higher than in the cases with negative metastasis. The intraglandular dissemination was definitely more frequent in the cases with recurrence or multiple occurrence than in the cases with single occurrence without recurrence. Based on these facts, recurrence is probably due to leaving the disseminated lesions in the remaining tissue, and the cases of multiple occurrence develop as die result of the growth of the intraglandular dissemination.

The postoperative outcome (including clinicopathologic features) in 19 patients with differentiated thyroid cancer of the isthmus was investigated to develop more appropriate surgical strategies for these lesions. The extent of thyroidectomy, including neck dissection, tumor size, nodal involvement, and other clinical features were evaluated. The incidence of intraglandular dissemination was about 16% in all patients. Analysis of regional node metastatic distribution revealed no definite metastatic pattern. In addition, there was no apparent correlation between tumor size and nodal involvement. Two of the six patients who underwent total thyroidectomy suffered permanent postoperative hypoparathyroidism. It is thus recommended that isthmusectomy, including an adequate edge of surrounding normal thyroid tissues of each lobe and modified or limited neck dissection when cervical nodes are palpably enlarged, is sufficient as an appropriate primary surgical procedure for differentiated carcinoma of the thyroid isthmus.

No abstract