PROBABILITY OF CANCER DETECTION DURING REPEATED OPERATIONS IN PATIENTS WITH BENIGN THYROID DISEASES
- Authors: Romanchishen AF1, Gostimsky AV1, Akinchev AL1, Karpatsky IV1
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Affiliations:
- Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice
- Issue: Vol 21, No 1 (2019)
- Pages: 94-98
- Section: Articles
- URL: https://journals.rcsi.science/1682-7392/article/view/13056
- DOI: https://doi.org/10.17816/brmma13056
- ID: 13056
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Abstract
Introduction. Suspected malignant growth in patients with recurrent goiter is one of the main causes of repeated operations. Focuses of carcinoma can be detected in patients operated on for multinodular goiter with compression of the organs of the neck, recurrent diffuse toxic goiter. Objective of investigation is to assess the risk of a malignant lesion of the thyroid remnant in patients with recurrent goiter, to justify the surgical tactics in this group of patients. Material and methods. In the St. Petersburg Center of Endocrine Surgery and Oncology 28138 patients with various thyroid diseases were operated on for the period from 1973 till 2016. Results. In a retrospective analysis of the group consisting of 1106 patients with recurrent goiter, a new thyroid disease was detected in 156 (14.1%) cases. Thyroid cancer in thyroid remnant was detected in 57 (36.5%) cases or 5.2% of all the patients with recurrent goiter. The work describes the risk of malignant lesion of the thyroid remnant in patients with recurrent goiter and surgical tactics in this group of patients. Conclusion. Cancer of the thyroid gland, as a new disease of the thyroid remnant, in patients previously operated on for benign thyroid pathology, is found in 5.2% of observations. The possibilities of fine-needle aspiration biopsy in this group are reduced. Active surgical tactics in cases of multinodular transformation of the thyroid remnant is justified. The operation of choice is reresection up to thyroidectomy. Careful intraoperative study of removed tissue and close cooperation with the morphological service helps to reduce the number of diagnostic and tactical errors in patients with both recurrent and ordinary multi-node goiter.
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##article.viewOnOriginalSite##About the authors
A F Romanchishen
Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice194100, Litovskaya Str., 2, St. Petersburg, Russia
A V Gostimsky
Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice194100, Litovskaya Str., 2, St. Petersburg, Russia
A L Akinchev
Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice194100, Litovskaya Str., 2, St. Petersburg, Russia
I V Karpatsky
Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice194100, Litovskaya Str., 2, St. Petersburg, Russia
References
- Акинчев А.Л., Романчишен А.Ф. Послеоперационный рецидивный зоб // Вестник хирургии им. И.И. Грекова. 2005. Т. 164. № 5. С. 43
- Воробьев С.Л., Зайцева И.В., Матвеева З.С. Информативность критериев цитологической диагностики новообразований щитовидной железы // Вестник хирургии им. И.И. Грекова. 2007. Т. 166. № 2. С. 62-64
- Гостимский А.В., Романчишен А.Ф., Гавщук М.В. Фотодинамическая терапия в комбинированном лечении больных недифференцированным раком щитовидной железы // Онкохирургия. 2013. Т. 5 (S1). С. 31-32.
- Романчишен А.Ф., Вабалайте К.В., Романчишен Ф.А. и соавт. Неотложные состояния в тиреоидной и паратиреоидной хирургии. Санкт-Петербург, 2014.
- Cappellani A., Di Vita M., Zanghì A et al. The recurrent goiter: prevention and management // Ann. Ital. Chir. 2008. Vol. 79(4). P. 247-253
- Cerci C., Cerci S.S., Eroglu E. et al. Thyroid cancer in toxic and non-toxic multinodular goiter // J Postgrad Med. 2007. Vol. 53. P. 157-160.
- Lefevre J., Tresallet C., Leenhardt L. et al. Reoperative surgery for thyroid disease // Langenbecks Arch Surg. 2007; Vol. 392(6). P. 685-691. doi: 10.1007/s00423-007-0201-6.
- Menegaux F., Turpin G., Dahman M., et al. Secondary thyroidectomy in patients with prior thyroid surgery for benign disease: a study of 203 cases // Surgery. 1999. Vol. 126. P. 479-483. doi: 10.1016/s0039-6060(99)70088-7
- Miccoli P., Minuto M.N., Galleri D. et al. Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. // ANZ J. Surg. 2006. Vol. 76. P. 123-126. doi: 10.1111/j.1445-2197.2006.03667.x
- Müller PE, Kabus S, Robens E, Spelsberg F. Indications, risks, and acceptance of total thyroidectomy for multinodular benign goiter // Surg. Today. 2001. N3. P. 958-962.
- Rudnicki J., Agrawal A.K., Jelen M. et al. Histopathological evaluation of recurrent goiter // Folia Histochem. Cytobiol. 2010. Vol. 48(3). P. 430-433. doi: 10.2478/v10042-010-0036-9.
- Tollin S.R., Mery G.M., Jelveh N. et al. The use of fine-needle aspiration biopsy under ultrasound guidance to assess the risk of malignancy in patients with a multinodular goiter // Thyroid. 2000. Vol. 10. P. 235-241. doi: 10.1089/thy.2000.10.235.
- Torre G., Barreca A., Borgonovo G. et al. Goiter recurrence in patients submitted to thyroid stimulating hormone suppression: possible role of insulin-like growth factors and insulin-like growth factor-binding proteins // Surgery. 2000. Vol. 127. P. 99-103. doi: 10.1067/msy.2000.100937.
- Yavuz H.C., Mete T., Irak L. et al. Malignancy and Complication Rate in Reoperation of Recurrent Goiter // Gazi Medical Journal. 2016. Vol. 27. P. 15-18.