Hemithyroidectomy: The Optimal Initial Surgical Approach for Individuals Undergoing Surgery for a Cytological Diagnosis of Follicular Neoplasm

Wiseman, Sam M.; Baliski, Christopher; Irvine, Robert; Anderson, Donald W.; Wilkins, G. E.; Filipenko, Douglas; Zhang, Hongbin; Bugis, Sam

doi:10.1245/aso.2006.03.089

Cited by 35 publications

(28 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8,[19][20][21] Male gender has also been found to be associated with malignancy in some studies, [19,22] while others found no difference between genders in terms of malignancy. [15,18,23] The results of multivariate analysis performed for this study demonstrated that suspicion of malignancy detected ultrasonographically was associated with risk of malignancy. Gharib et al [10] reported that sonographic characteristics of malignant thyroid nodules were irregular boundaries, the presence of calcification, hypoechogenicity, vascular abnormalities, and increased size.…”

Section: Discussionmentioning

confidence: 66%

“…Other authors have also indicated the lack of any correlation between age and increase in the risk of malignancy. [15,17,18] However, in one study, patient age was demonstrated to be a marker for malignancy. [8,[19][20][21] Male gender has also been found to be associated with malignancy in some studies, [19,22] while others found no difference between genders in terms of malignancy.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Atypia of Undetermined Significance on Thyroid Fine Needle Aspiration Cytology: Pathological Evaluation and Risk Factors for Malignancy

Akın¹

2017

South Clin Ist Euras

View full text Add to dashboard Cite

Objective:This study was performed to analyze the surgical pathology results of thyroid fine-needle aspiration (FNA) cytology categorized as atypia of undetermined significance (AUS). Results: A total of 44 female patients and 11 male patients were included in this study. Among the 55 cases, 27 (49.1%) had final diagnosis of malignancy and 28 (50.9%) had benign lesions according to pathological evaluation. Both univariate and multivariate analysis revealed that only ultrasonographic finding of suspected malignancy was associated with malignant pathology. Conclusion:The risk for malignancy should be determined in the initial stage and high-risk patients with cytology classified as AUS should be recommended for surgery. In this study, the patients had a high preoperative risk of malignancy; thus, our pathological results had a high rate of malignancy.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 98%

Atypia of Undetermined Significance on Thyroid Fine Needle Aspiration Cytology: Pathological Evaluation and Risk Factors for Malignancy

Akın¹

2017

South Clin Ist Euras

View full text Add to dashboard Cite

show abstract

“…There are also currently no patient or tumor characteristics that can reliably predict the presence of cancer in individuals diagnosed with a thyroid neoplasm of Hurthle cell or follicular subtype. 3,4 Thus, when a thyroid tumor with this indeterminate cytology is identified by FNAB, the current recommended approach is a diagnostic operation for removal of either a portion of or the entire thyroid gland. [3][4][5] In addition to the emotional distress experienced by patients who undergo surgery for a possible cancer diagnosis, thyroid resection carries a low but significant risk of permanent injury to associated parathyroid glands and nerves that may lead to the need for life-long calcium supplementation or voice dysfunction, and extremely uncommonly the need for a long term tracheostomy.…”

mentioning

confidence: 99%

“…Indeed, only approximately one in five patients undergoing thyroid resection for indeterminant FNAB cytology will eventually be diagnosed with a thyroid cancer by histopathological evaluation. 3 Study of the molecular characteristics of thyroid cancer has allowed for the development of potential molecular diagnostic tools. In the largest thyroid cancer diagnostic marker panel study reported to date, we recently found Galectin-3 (Gal-3) to be the most accurate standalone marker for differentiated thyroid cancer diagnosis (DTC) when compared with a panel of 56 other molecular markers.…”

mentioning

confidence: 99%

Diagnostic Utility of Galectin-3 in Thyroid Cancer

Chiu

Strugnell

Griffith

et al. 2010

The American Journal of Pathology

Self Cite

136

View full text Add to dashboard Cite

Galectin-3 (Gal-3), which has received significant recent attention for its utility as a diagnostic marker for thyroid cancer, represents the most well-studied molecular candidate for thyroid cancer diagnosis. Gal-3 is a protein that binds to ␤-galactosidase residues on cell surface glycoproteins and has also been identified in the cytoplasmic and nuclear compartment. This marker has been implicated in regulation of normal cellular proliferation and apoptosis, as well as malignant transformation and the metastasis of cancer cells. We here present a mechanistic review of Gal-3 and its role in cancer development and progression. Gal-3 expression studies in thyroid tissue and cytologic tumor specimens and their methodological considerations are also discussed in this article. Despite great variance in their methodology, the majority of immunohistochemical studies found that Gal-3 was differentially expressed in thyroid carcinoma compared with benign and normal thyroid specimens, suggesting that Gal-3 is a good diagnostic marker for thyroid cancer. Recent studies have also demonstrated improved methodological reliability. On the other hand, Gal-3 genomic expression studies have shown inconsistent results for diagnostic utility and are not recommended. Overall, the development of Gal-3 as a diagnostic marker for thyroid cancer represents a promising avenue for future study, and its clinical application could significantly reduce the number of diagnostic thyroid operations performed for cases of indeterminant fine needle aspiration biopsy cytology, and thus positively impact the current management of thyroid nodular disease. (Am J

show abstract

“…Consistent with the current literature, in prior reports of our experience, only about 1 in 5 patients undergoing thyroid operation for FN or HN were eventually found by histopathologic evaluation to have cancer. 17,18 Hemithryoidectomy was considered to be adequate definitive treatment in 96% of individuals with FN and 82% with HN diagnosed preoperatively with FNAB cytology.…”

mentioning

confidence: 99%

Hemithyroidectomy is the preferred initial operative approach for an indeterminate fine needle aspiration biopsy diagnosis

et al. 2012

Self Cite

View full text Add to dashboard Cite

Hemithyroidectomy is the preferred initial operative approach for an indeterminate fine needle aspiration biopsy diagnosis Background: Fine needle aspiration biopsy represents the critical initial diagnostic test used for evaluation of thyroid nodules. Our objectives were to determine the cytological distribution, the utility of clinicopathologic characteristics for predicting malignancy and the true proportion of cancer among individuals who presented with indeterminate cytology and had undergone thyroid surgery for suspicion of cancer. Methods:We retrospectively reviewed 1040 consecutive primary thyroid operations carried out over an 8-year period at a tertiary care endocrine referral centre. Follicular neoplasm (FN), Hürthle cell neoplasm (HN), neoplasms suspicious for but not diagnostic of papillary carcinoma (IP) and neoplasms with cellular atypia (IA) were reviewed. Results:In all, 380 individuals presented with cytologically indeterminate thyroid nodules. Of these, 252 (66%) patients had FN, 47 (12%) HN, 44 (12%) IP, 26 (7%) IA and 11 (4%) had mixed diagnoses. Biopsied lesions were found to be malignant on pathological evaluation in 102 (27%) patients: 49 (19%) with FN, 11 (23%) HN, 28 (64%) IP and 9 (35%) with IA. Hemithyroidectomy was adequate definitive treatment in 196 of 225 (87%) patients with FN and 39 of 42 (93%) with HN. Significant associations with a cancer diagnosis were identified for smaller tumour size in patients with FN (p = 0.004) and right thyroid lobe location in patients with IP (p = 0.012), although these factors were nonsignificant in the corrected analyses for multiple comparisons. Conclusion:In a review of the experience at a Canadian centre, 4 operations were carried out to identify each cancer, and hemithyroidectomy was the optimal initial and definitive surgical approach for most patients.Contexte : La biopsie par aspiration à l'aiguille fine représente un test diagnostique initial crucial pour évaluer les nodules de la thyroïde. Nos objectifs consistaient à déter-miner la distribution cytologique, l'utilité des caractéristiques clinico-pathologiques pour la prédiction des cancers et la proportion réelle de cancers chez des personnes dont les résultats cytologiques étaient indéterminés et qui ont subi une chirurgie de la thyroïde pour un cancer présumé. Méthodes :Nous avons passé en revue de façon rétrospective 1040 interventions thyroïdiennes primaires consécutives effectuées sur une période de 8 ans dans un centre de soins endocriniens tertiaires. Nous avons examiné les cas de néoplasie folliculaire (NF), de néoplasie à cellules de Hürthle (NCH), de néoplasies papillaires présumées mais non avérées (indéterminées, NPI), de même que les néoplasies à cellules atypiques (NCA).Résultats : En tout, 380 patients ont présenté des nodules thyroïdiens indéterminés à la cytologie. Parmi eux, 252 (66 %) présentaient une NF, 47 (12 %) une NCH, 44 (12 %) une NPI, 26 (7 %) une NCA et 11 (4 %) présentaient un diagnostic mixte. Les lésions soumises à la biopsie se sont révélées malignes à l'...

show abstract

Hemithyroidectomy: The Optimal Initial Surgical Approach for Individuals Undergoing Surgery for a Cytological Diagnosis of Follicular Neoplasm

Cited by 35 publications

References 33 publications

Atypia of Undetermined Significance on Thyroid Fine Needle Aspiration Cytology: Pathological Evaluation and Risk Factors for Malignancy

Atypia of Undetermined Significance on Thyroid Fine Needle Aspiration Cytology: Pathological Evaluation and Risk Factors for Malignancy

Diagnostic Utility of Galectin-3 in Thyroid Cancer

Hemithyroidectomy is the preferred initial operative approach for an indeterminate fine needle aspiration biopsy diagnosis

Contact Info

Product

Resources

About