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Revista argentina de endocrinología y metabolismo

versión On-line ISSN 1851-3034

Resumen

LADENHEIM, S; FILIPPONI, A; YGLESIAS, J  y  CANONACO, E. Review of Indication for Thyroidectomy and its Correlation with the Pathological Anatomy. Rev. argent. endocrinol. metab. [online]. 2013, vol.50, n.1, pp.42-49. ISSN 1851-3034.

Objective: 1. To determine the percentage of malignant thyroid pathology in thyroidectomy in an Hospital inside the province of Buenos Aires. 2. To evaluate the indication for thyroidectomy due to medical and/or cytological reasons relating them to the pathological anatomy. Materials and Methods: We retrospectively evaluated the medical records of 214 patients who had a thyroid surgery from June 2004 to June 2010, relating the surgical indication to the pathological anatomy. For its analysis, the patients were divided into two groups: 1) those ones who were treated as thyroidectomy using medical criteria such as: a large endothoracic goiter, a fast growing nodule, firmness, etc. These patients showed negative or unsatisfactory thyroid cytology (n = 152); 2) those ones who were treated as thyroidectomy because they showed a cytology suspected to be malignant (n = 62). Results: From 214 patients evaluated, 203 were women and 11 men, with an average age of 43.3 years old (17-64 years old); a total thyroidectomy was carried out in 117 cases and a subtotal one in 97 cases. Of all the patients 98 % (n = 210) had thyroid fine needle aspiration (FNA), 24.7 % of which were unsatisfactory. Seventeen patients had temporary hypoparathyroidism (7.9 %), 3 patients had permanent one (1.4 %) and 3 patients had unilateral vocal cord paralysis (1.4 %). Of all the cases 21.5 % (n = 46) showed malignant pathology. From 152 patients who had surgery due to medical criteria, 10.5 % (n=16) showed malignancy; whereas the patients who had surgery for FNA (n = 62) suspected to be malignant showed thyroid cancer in 48.4 % (n = 30). From the patients with nodular goiter operated due to medical criteria having unsatisfactory FNA (n = 50), 14 patients had carcinoma (28 %). Conclusions: From the total of patients with thyroidectomy we have found a high percentage of benign pathology (78.5 %). From the patients with nodular goiter who were operated due to medical criteria, with unsatisfactory cytology, 28 % were malignant. We consider that it is essential to use cytological criteria upon the thyroidectomy indication however, if there were high percentage of unsatisfactory cytology, it would be necessary to check the diagnostic methodology where we work.

Palabras clave : Indication; Thyroidectomy; Pathological anatomy.

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