Indications of Surgical Treatment ofPrimary Extranodal Non-Hodgkin Lymphomas of the Thyroid Gland

Overview

S u m m a ry:
The authors sumarize recent information on primary extranodal malignant lymphomas(NHL) in the thyroid gland. They supplement the data by their own experience with surgicaltreatment of NHL of the thyroid gland. They provide evidence that surgical removal of the thyroidgland can be considered a possible therapeutic modality of primary NHL of the thyroid gland. Theydo not recommend surgical treatment in patients where NHL affects not only the thyroid gland butis also in the lymph nodes or other organs.The authors analyze a group of patients operated in 1991-1998 at the Clinic of otolaryngology andsurgery of the head and neck of the First Medical Faculty Charles University and ENT chair of IPVZin Prague for malignant non-Hodgkin lymphoma (NHL) of the thyroid gland.The group comprised one man (71%) and 13 (92.9%) women. The male/female ratio in the group withNHL is 1:13. The mean age of the group was 66 years.All patients operated for NHL were treated after surgical removal of the thyroid gland by othertherapeutic modalities (actinotherapy, chemotherapy). Surgery was indicated in the initial stageas cytoreduction of the basic disease. In all patients after surgery healing per primam was recorded.Five-year survival after initial therapy was evaluated in 9 (64.3%) patients and survival in this groupwas 8 (88.8%) patients. As a whole at present 11 (78.7%) patients survive incl. one female patient(7.1%) with persistence of the disease. Three patients (21.3%) died. Due to generalization andadvanced basic disease (NHL) two patients died (14.2%), in one patient (7.1%) the association withNHL was not proved.The authors conclude that primary NHL of the thyroid gland is an indication for total thyroidecto-my. Subsequent treatment then follows the therapeutic protocol of NHL.

Key words:
malignant non-Hodgkin lymphoma, thyroid gland, indication for surgery,thyroidectomy.