Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease

Paolo Miccoli, Michele N. Minuto, David Galleri, Jacopo D'Agostino, Fulvio Basolo, Lucia Antonangeli, Fabrizio Aghini-Lombardi, Piero Berti

Research output: Contribution to journalArticle

Abstract

Background: The diagnosis of incidental thyroid carcinoma (ITC) in patients operated on for a benign disease is frequent. This study aims to determine both its clinical effect and the possibility of identifying this class of patients preoperatively. Methods: A total of 998 consecutive patients (697 women and 301 men; mean age, 49.5 years) undergoing surgery for benign thyroid pathology in a single institution were studied. The mean time between first diagnosis of thyroid disease and operation was 9.0 years (range, 0-50 years). All patients underwent at least one ultrasonography before surgery, and 678 patients underwent fine-needle aspiration cytology. Patients with undetermined cytology or follicular nodules were excluded from the study. Results: Histology revealed an ITC in 104 patients (10.4%): 99 had a papillary carcinoma. Mean and median diameters of ITC were 1.4 and 0.7 cm, respectively (range, 0.1-7.5 cm). In 43 patients, the tumour size was greater than 1 cm, whereas it exceeded 2 cm in 25 patients. Tumours were multicentric in 19.8% of the patients and occurred in 8.2% of patients with nodular toxic goiter, 8.7% of patients with toxic diffuse goiter and 13.8% of patients with multinodular goiter. Discussion: The results confirm the high frequency of ITC. ITC was more frequent in euthyroid patients than in thyrotoxic patients (P <0.03). Sex, age, thyroid volume and interval between diagnosis and surgery did not significantly influence its incidence. The majority of ITC was represented by microcarcinomas, but in approximately 25% of patients, the tumour size was greater than 2 cm. The role played by FNAC in excluding malignancies proved to be fairly inconclusive.

Original languageEnglish
Pages (from-to)123-126
Number of pages4
JournalANZ Journal of Surgery
Volume76
Issue number3
DOIs
Publication statusPublished - Mar 2006

Fingerprint

Thyroid Diseases
Thyroid Neoplasms
Poisons
Goiter
Cell Biology
Neoplasms
Thyroid Gland
Nodular Goiter
Papillary Carcinoma
Fine Needle Biopsy

Keywords

  • Benign thyroid disease
  • Fine-needle aspiration cytology
  • Thyroid carcinoma

ASJC Scopus subject areas

  • Surgery

Cite this

Miccoli, P., Minuto, M. N., Galleri, D., D&apos;Agostino, J., Basolo, F., Antonangeli, L., ... Berti, P. (2006). Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. ANZ Journal of Surgery, 76(3), 123-126. https://doi.org/10.1111/j.1445-2197.2006.03667.x

Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. / Miccoli, Paolo; Minuto, Michele N.; Galleri, David; D&apos;Agostino, Jacopo; Basolo, Fulvio; Antonangeli, Lucia; Aghini-Lombardi, Fabrizio; Berti, Piero.

In: ANZ Journal of Surgery, Vol. 76, No. 3, 03.2006, p. 123-126.

Research output: Contribution to journalArticle

Miccoli, P, Minuto, MN, Galleri, D, D&apos;Agostino, J, Basolo, F, Antonangeli, L, Aghini-Lombardi, F & Berti, P 2006, 'Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease', ANZ Journal of Surgery, vol. 76, no. 3, pp. 123-126. https://doi.org/10.1111/j.1445-2197.2006.03667.x
Miccoli, Paolo ; Minuto, Michele N. ; Galleri, David ; D&apos;Agostino, Jacopo ; Basolo, Fulvio ; Antonangeli, Lucia ; Aghini-Lombardi, Fabrizio ; Berti, Piero. / Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. In: ANZ Journal of Surgery. 2006 ; Vol. 76, No. 3. pp. 123-126.
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abstract = "Background: The diagnosis of incidental thyroid carcinoma (ITC) in patients operated on for a benign disease is frequent. This study aims to determine both its clinical effect and the possibility of identifying this class of patients preoperatively. Methods: A total of 998 consecutive patients (697 women and 301 men; mean age, 49.5 years) undergoing surgery for benign thyroid pathology in a single institution were studied. The mean time between first diagnosis of thyroid disease and operation was 9.0 years (range, 0-50 years). All patients underwent at least one ultrasonography before surgery, and 678 patients underwent fine-needle aspiration cytology. Patients with undetermined cytology or follicular nodules were excluded from the study. Results: Histology revealed an ITC in 104 patients (10.4{\%}): 99 had a papillary carcinoma. Mean and median diameters of ITC were 1.4 and 0.7 cm, respectively (range, 0.1-7.5 cm). In 43 patients, the tumour size was greater than 1 cm, whereas it exceeded 2 cm in 25 patients. Tumours were multicentric in 19.8{\%} of the patients and occurred in 8.2{\%} of patients with nodular toxic goiter, 8.7{\%} of patients with toxic diffuse goiter and 13.8{\%} of patients with multinodular goiter. Discussion: The results confirm the high frequency of ITC. ITC was more frequent in euthyroid patients than in thyrotoxic patients (P <0.03). Sex, age, thyroid volume and interval between diagnosis and surgery did not significantly influence its incidence. The majority of ITC was represented by microcarcinomas, but in approximately 25{\%} of patients, the tumour size was greater than 2 cm. The role played by FNAC in excluding malignancies proved to be fairly inconclusive.",
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