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Thyroid carcinoma, ten-years file


Authors: J. Šafránek 1;  V. Třeška 1;  T. Skalický 1;  V. Špidlen 1;  J. Doležal 1;  D. Kubačková 1;  J. Zeithaml 1;  M. Skála 1;  P. Hošek 2
Authors‘ workplace: Chirurgická klinika, Lékařská fakulta v Plzni, Univerzita Karlova v Praze, přednosta: prof. MUDr. V. Třeška, DrSc. 1;  Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova v Praze, vedoucí manažer: doc. Ing. J. Hrabák, Ph. D. 2
Published in: Rozhl. Chir., 2016, roč. 95, č. 11, s. 394-397.
Category: Original articles

Overview

Introduction:
Even though thyroid carcinoma has, in general, a good prognosis and low mortality rate, its incidence, especially the incidence of early forms of the disease has been growing.

Method:
Retrospective analysis of the file of surgeries of documented thyroid carcinoma within the years of 2006–2015.

Results:
Thyroid carcinoma was recorded in 145 of 1820 patients operated for thyreopathy (8%); microcarcinoma (<10mm) was recorded in 64 cases (44.1%). The carcinoma was mostly detected accidentally during total thyroidectomy, which was in 70 cases (48.3%). The carcinoma was expected in 35 cases (24.1%) on the basis of prior puncture and total thyroidectomy was carried out straight away. Perioperative histology after hemithyroidectomy was requested in 31 cases (21.4%), and it was found positive only in 13 cases; thyroidectomy was finished in the second period in the other cases. Due to advanced carcinoma, tumour exploration/debulking was performed in 3 cases (2.1%) – for anaplastic carcinoma in all these cases. A permanent unilateral lesion – n. laryngeus recurrens – occurred in 3 cases (2.1%); a permanent bilateral lesion was recorded twice (1.4%).

The most frequently manifested carcinoma was the papillary carcinoma in 114 patients (78.6%; 83 women/31 men; age of 12−84 years; mean age of 50.6), the second most frequent carcinoma was the follicular carcinoma in 16 patients (11.0%; 15/1; 19−69; 55.3), followed by the medullary carcinoma in 10 patients (6.9%; 6/4; 25−76; 58.1). Anaplastic carcinoma was detected only in 4 cases (2.8%; 2/2; 64−87; 75.5), and lymphoma of the thyroid gland occurred twice as well as Hürtle cell carcinoma.

Conclusion:
Thyroid carcinoma is mostly found accidentally during surgery in the early phase of the disease. This proves the high quality of endocrinology care and the correctness of the tendency to indicate early surgical treatment of thyroidal pathology.

Key words:
thyroid carcinoma – thyroidectomy − complications


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