Anaplastic Thyroid Carcinomas Incidentally Found on Postoperative Pathological Examination

Yoshida, Akira; Sugino, Kiminori; Sugitani, Iwao; Miyauchi, Akira

doi:10.1007/s00268-014-2536-9

Cited by 22 publications

(16 citation statements)

References 19 publications

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“…The other types, namely follicular and non-differentiated carcinoma, were found in 4% and 2% of the MNG patients, respectively. Yoshida et al [42] presented 675 cases of anaplastic TC, 5% of which were incidental in nature. They noted that for this type of thyroid malignancy, only incidental anaplastic carcinoma was curable.…”

Section: Discussionmentioning

confidence: 99%

Should the Prevalence of Incidental Thyroid Cancer Determine the Extent of Surgery in Multinodular Goiter?

et al. 2016

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BackgroundThe most appropriate surgical procedure for multinodular goiter (MNG) remains under debate. Incidental thyroid carcinoma (ITC) is often identified on histopathological examination after thyroidectomy performed for presumed benign MNG.Aim of the studyThe aim of the study was to determine the value of radical surgery for MNG patients considering the prevalence of ITC diagnosed postoperatively.Materials and MethodsWe conducted retrospective analysis of the medical records of 2,306 patients surgically treated for MNG between 2008 and 2013 at one center. None of the patients presented with any suspicion of malignancy, history of familial thyroid cancer, multiple endocrine neoplasia syndrome or previous head or neck radiation exposure.ResultsAmong the 2,306 MNG patients, ITC was detected in 49 (2.12%) (44 women and 5 men, with average ages of 52.2 (21–79) and 55.6 (52–62), respectively). Papillary thyroid carcinoma was significantly more frequently observed than other types of ITC (p<0.00001). Among the MNG patients, 866 (37.5%) underwent total/near total surgery, 464 (20.1%) received subtotal thyroidectomy, and 701 (30.3%) received the Dunhill operation. The remaining 275 (11.9%) patients underwent a less radical procedure and were classified as "others." Among the 49 (100%) patients with ITC, 28 (57.1%) underwent radical surgery. Another 21 (42.9%) patients required completion surgery due to an insufficient primary surgical procedure. A total of 21 (2.42%) patients in the total/near total surgery group were diagnosed with ITC, as well as 16 (2.48%) in the subtotal thyroidectomy group and 12 (1.71%) in the Dunhill operation group; 21 (100%), 4 (25%) and 3 (25%) of these patients, respectively, underwent radical surgery; thus, 0 (0%), 12 (75%) and 9 (75%) required completion surgery. The prevalence rates of ITC were comparable between the radical and subtotal surgery groups (2.42% and 3.44%, respectively, p = 0.4046), and the prevalence was higher in the radical surgery group than in the Dunhill operation group (2.42% and 1.71%, respectively, p = 0.0873). A significant difference was observed between the group of patients who underwent total/near total surgery, among whom all of the patients with ITC (100%) received primary radical surgery, and the groups of patients who received the subtotal and Dunhill operations, among whom only 25% of the patients with ITC in each group received primary radical surgery (p<0.0001).ConclusionsMore radical procedures for MNG result in a lower risk of reoperation for ITC. The prevalence of ITC on postoperative histopathological examination should determine the extent of surgery in MNG patients. In the future, total/near total thyroidectomy should be considered for MNG patients due to the increased prevalence of ITC to avoid the necessity for reoperation.

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Section: Discussionmentioning

confidence: 99%

Should the Prevalence of Incidental Thyroid Cancer Determine the Extent of Surgery in Multinodular Goiter?

et al. 2016

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“…Up to half of ATC samples may contain a well‐differentiated component, usually antecedent or coexisting PTC and FTC, or occasionally a minor ATC component is found on postoperative pathological examination of patients with differentiated thyroid carcinoma . Recent Korean studies addressed a significance of coincident ATC and PTC/FTC .…”

Section: Anaplastic (Undifferentiated) Carcinomamentioning

confidence: 99%

“…193 Up to half of ATC samples may contain a well-differentiated component, usually antecedent or coexisting PTC and FTC, or occasionally a minor ATC component is found on postoperative pathological examination of patients with differentiated thyroid carcinoma. 194 Recent Korean studies addressed a significance of coincident ATC and PTC/FTC. 195,196 It was reported that pure ATC (100% undifferentiated component) and ATC arising from PTC/FTC (>10% undifferentiated component, usually > 50%) have a similar behavior and unfavorable prognosis.…”

Section: Anaplastic (Undifferentiated) Carcinomamentioning

confidence: 99%

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Kakudo

Bychkov

Bai

et al. 2018

Pathology International

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“…It is then argued if incidental carcinomas also include the carcinomas discovered at the definitive histological examination, after total thyroidectomy for multinodular goiter (26)(27)(28)(29)(30)(31)(32)(33) or during treatment of an unrelated head and neck cancer (34). There is no doubt that the latter are also an occasional finding within parenchymas where multinodularity and poor response to medical therapy become responsible for an inalienable surgical choice.…”

Section: Introductionmentioning

confidence: 99%

Incidental thyroid carcinomas. A retrospective study

Maturo¹

2017

GCHIR

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Anaplastic Thyroid Carcinomas Incidentally Found on Postoperative Pathological Examination

Abstract: Incidental ATC is the only curable type of ATC, and further studies are needed to establish the effectiveness of additional postoperative radiotherapy and/or chemotherapy in incidental ATC.

Cited by 22 publications

References 19 publications

Should the Prevalence of Incidental Thyroid Cancer Determine the Extent of Surgery in Multinodular Goiter?

Should the Prevalence of Incidental Thyroid Cancer Determine the Extent of Surgery in Multinodular Goiter?

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Incidental thyroid carcinomas. A retrospective study

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