Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens

Rosen, Yale; Rosenblatt, Philip; Saltzman, Eric I.

doi:10.1002/1097-0142(19901101)66:9<2001::aid-cncr2820660926>3.0.co;2-x

Cited by 58 publications

(23 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We designated the sensitivity of FS analysis as 58%. This rate was similar to those of some other studies in the literature [1,6,13,14]. The inability to diagnose papillary microcarcinoma, follicular variant of papillary carcinoma and follicular carcinoma intraoperatively with FS was the major factor accounting for the low sensitivity of FS.…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

The Ongoing Debate In Thyroid Surgery: Should Frozen Section Analysis Be Omitted?

et al. 2007

View full text Add to dashboard Cite

Abstract. Controversies concerning the role of frozen section (FS) have been a matter of debate. The aim of this study was to identify the role of FS analysis in intraoperative decision making and analyze the effect of the cost in detecting thyroid malignancies in Turkey. Out of 214 consecutive patients who had been operated on for thyroid cancer between January 1996 and August 2004, 178 patients were evaluated retrospectively. All 178 patients were subjected to FS. Intraoperative FS correctly identified the pathology as malignant in 58.4% of patients. A true-positive FS result changed the surgical strategy in 30 (27.6%) cases False negative FS lesions were defined histologically as papillary microcarcinoma in 54%, follicular variant of papillary cancer in 18% and follicular cancer in 8% of cases. The sensitivities of FNAB and intraoperative FS in thyroid cancer patients were 22.5% and 58.4%, respectively. False negative FS results increased the cost for each informative FS from €25 to €42.7. Despite limitations, results of this study reject the idea that the role of FS is becoming limited. We recommend routine frozen section in the operative assessment of thyroid nodules. Omitting FS may be suggested only in cases with a FNAB revealing malignancy.

show abstract

Section: Discussionsupporting

confidence: 89%

“…The extent of surgery still remains controversial [3]. While developments and controversies in thyroid surgery are ongoing, the benefit of frozen section (FS) has been a matter of debate between experts [1,[4][5][6][7][8][9][10].…”

mentioning

confidence: 99%

The Ongoing Debate In Thyroid Surgery: Should Frozen Section Analysis Be Omitted?

et al. 2007

View full text Add to dashboard Cite

show abstract

“…However, only 5 per cent of thyroid nodules are malignant 1 . Diagnostic procedures to evaluate thyroid nodules include radionuclide scanning and ultrasonography, but ®ne-needle aspiration biopsy (FNAB) is the most effective test in selecting the patients who require surgery 2 .…”

Section: Introductionmentioning

confidence: 99%

Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules

Caraci

Aversa

Mussa

et al. 2002

British Journal of Surgery

View full text Add to dashboard Cite

Background: The role of routine frozen section (FS) in the surgical management of thyroid nodules remains uncertain. This study reviewed the role of FS in the presence of an adequate ®ne-needle aspiration biopsy (FNAB).Methods: FNAB and FS were evaluated in 206 patients who had surgery for a thyroid nodule. Cytological specimens were classi®ed as benign, malignant or suspicious. The FS diagnoses were benign, malignant or deferred.Results: A cytological diagnosis was obtained in 93 nodules; the remaining 113 were classi®ed as suspicious, of which 21 were malignant on de®nitive examination. The overall accuracy of FNAB was 53 per cent. FS evaluation identi®ed 165 lesions as benign; the diagnosis was deferred until de®nitive histological evaluation in only eight. The overall accuracy, therefore, was 96 per cent. Routine use of FS was cost-effective; lowering the number of reoperations led to an estimated saving of about 40 per cent.Conclusion: These data suggest that FS remains an important tool in the surgical management of thyroid nodules and can reduce the number of patients requiring reoperation.

show abstract

“…However, FS is usually insufficient to determine true capsular or vascular invasion and deferral to a final pathologic diagnosis is often necessary in the setting of a follicular lesion [29]. Currently, preoperative fine needle aspiration (FNA) and intraoperative FS examination should be regarded as complementary procedures which, in some patients, may provide more diagnostic information than either procedure alone [8]. FS analysis often complements the fine needle aspiration cytology in cases with cytologic atypia or suspicious appearance, and is most useful at making a diagnosis of papillary thyroid carcinoma [28].…”

Section: Discussionmentioning

confidence: 99%

The Value of Intra-Operative Frozen Section in Thyroid Neoplasm Management: Experience of One Center

Jouini¹,

Abdessayed²,

Koubba-Mahjoub³

et al. 2017

Thyroid Disorders Ther

View full text Add to dashboard Cite

Aim: To review our own experience with Frozen section (FS) in thyroid surgery and to assess its value in the management of patients with thyroid disease. Methods:This retrospective study examined the results of 1110 frozen sections of thyroid specimens analyzed over the 10 year period from 2003 through 2012 and their correlations with the final histological examination. Deferred responses were not taken into account for statistical calculations.Results: In our series, FS and final histopathological diagnosis agreed in 85.4% and disagreed in 5.5%. 9.1% of the cases were deferred. The global specificity and sensitivity of FS analysis for all histological subtypes were 99.3% and 64.7% respectively. Its sensitivity for papillary carcinoma was 61.7%, 83.3% for follicular carcinoma and 100% for anaplastic carcinoma. Discordances were due to 6 false-positive diagnoses and 55 false-negative (FN) diagnoses. 50% of FN was represented by papillary micro-carcinoma. The positive predictive value (PPV) of the FS examination was 94.4% and its negative predictive value (NPV) was 93.9%. Conclusions:Our data supports the utility of intraoperative FS in the confirmation of malignancy of thyroid nodules. It's correlated with a high degree of specificity and an acceptable rate of sensitivity. Most of the discordances between FS and final histopathological diagnosis were explained by papillary microcarcinoma.

show abstract

Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens

Cited by 58 publications

References 10 publications

The Ongoing Debate In Thyroid Surgery: Should Frozen Section Analysis Be Omitted?

The Ongoing Debate In Thyroid Surgery: Should Frozen Section Analysis Be Omitted?

Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules

The Value of Intra-Operative Frozen Section in Thyroid Neoplasm Management: Experience of One Center

Contact Info

Product

Resources

About