Surgical anatomy of the pyramidal lobe in cancer patients: A Prospective Cohort in a Tertiary Centre

Irawati, Nina; Vaish, Richa; Chaukar, Devendra; Deshmukh, Anuja; D’Cruz, Anil

doi:10.1016/j.ijsu.2016.04.051

Cited by 6 publications

(11 citation statements)

References 14 publications

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“…The PL is known as an ancillary lobe of the thyroid gland, correlating with the caudal end of the embryologic thyroglossal duct. Its prevalence in literature ranges from 35.7 to 60.0% in cadaver studies and from 12.3 to 61.0% when assessed during thyroid surgery [1][2][3][4][5][6][7][8][9][10]. In the present study, we observed a prevalence of 80%, which is markedly higher than what was previously reported.…”

Section: Prevalence Of the Pyramidal Lobecontrasting

confidence: 59%

“…-Caudal: Thyroid isthmus. [2] 58.1% (61/105) Ozgur et al [3] 60.0% (24/40) Prakash et al [4] 35.7% (25/70) Milojevic et al [5] 55.2% (32/58) Surgery-based studies Geraci et al [6] 12.3% (74/604) Zivic et al [7] 61.0% (61/100) Kim et al [8] 59.8% (79/132) Ryu et al [9] 60.0% (81/135) Irawati et al [10] 36.9% (38/103) -Cranial: Approximately 1 cm cranial of the thyroid isthmus. -Lateral: lateral border of the infrahyoidal muscles.…”

Section: Methodsmentioning

confidence: 99%

“…In To improve the exposure of the anterior cervical structures, the post-mortem nature of our study allowed us to perform larger skin incisions than normally required for hemi-/thyroidectomy in vivo. Furthermore, the patients included in these studies underwent thyroid surgery for various pathologies of the thyroid gland, potentially creating a selection bias [6][7][8][9][10]. While we cannot ensure the exact representation of the general Austrian population with our study sample, we aimed to minimize any sort of bias by randomly selecting body donors at our institution.…”

Section: Prevalence Of the Pyramidal Lobementioning

confidence: 99%

“…The pyramidal lobe (PL) is an accessory lobe of the thyroid gland, consisting of thyroid tissue that remains at the caudal end of the obliterated thyroglossal duct. Its varying prevalence in previous studies ranged from 35.7 to 60.0% in cadaver studies [1][2][3][4][5] and from 12.3 to 61.0% in surgical studies [6][7][8][9][10], as showcased in Table 1.…”

Section: Introductionmentioning

confidence: 99%

“…On the contrary, the PL can be affected by the same pathologies as the rest of the thyroid gland. Hence, it may be afflicted in generalized thyroid disease as well as multifocal thyroid carcinoma [6,7,10]. The PL has been reported as the primary site of papillary and folliculary thyroid carcinoma in multiple case series [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound for the detection of the pyramidal lobe of the thyroid gland

Freilinger

Kaserer²,

Zettinig³

et al. 2022

J Endocrinol Invest

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Purpose The pyramidal lobe (PL) is an ancillary lobe of the thyroid gland that can be affected by the same pathologies as the rest of the gland. We aimed to assess the diagnostic performance of high-resolution sonography in the detection of the PL with verification by dissection and histological examination. Methods In a prospective, cross-sectional mono-center study, 50 fresh, non-embalmed cadavers were included. Blinded ultrasound examination was performed to detect the PL by two investigators of different experience levels. If the PL was detected with ultrasound, dissection was performed to expose the PL and obtain a tissue sample. When no PL was detected with ultrasound, a tissue block of the anterior cervical region was excised. An endocrine pathologist microscopically examined all tissue samples and tissue blocks for the presence of thyroid parenchyma. Results The prevalence of the PL was 80% [40/50; 95% CI (68.9%; 91.1%)]. Diagnostic performance for both examiners was: sensitivity (85.0%; 42.5%), specificity (50.0%; 60.0%), positive predictive value (87.2%; 81.0%), negative predictive value (45.5%; 21.0%) and accuracy (78.0%; 46.0%). Regression analysis demonstrated that neither thyroid parenchyma echogenicity, thyroid gland volume, age nor body size proved to be covariates in the accurate detection of a PL (p > .05). Conclusion We report that high-resolution ultrasound is an adequate examination modality to detect the PL. Our findings indicate a higher prevalence than previously reported. Therefore, the PL may be regarded as a regular part of the thyroid gland. We also advocate a dedicated assessment of the PL in routine thyroid ultrasound.

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Section: Prevalence Of the Pyramidal Lobecontrasting

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Section: Prevalence Of the Pyramidal Lobementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound for the detection of the pyramidal lobe of the thyroid gland

Freilinger

Kaserer²,

Zettinig³

et al. 2022

J Endocrinol Invest

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The prevalence and anatomy of the pyramidal lobe of the thyroid gland: A meta‐analysis with implications for thyroid surgery

et al. 2023

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The pyramidal lobe (PL), also known as the third lobe of the thyroid gland or lobe of Lalouette is an embryological remnant of the caudal end of the thyroglossal tract. The following meta‐analysis aims to provide a detailed analysis of the anatomical variations of the PL using the available data in the literature. Major online medical databases such as PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched in order to find all studies considering the prevalence and anatomy of the PL of the thyroid gland. Finally, a total of 24 studies that met the required criteria and contained complete and relevant data were included in the present meta‐analysis. The pooled prevalence of the PL was found to be 42.82% (95% CI: 35.90%–49.89%). An analysis showed that the mean length was 23.09 mm (SE: 0.56). The mean width was found to be 10.59 mm (SE: 0.77). The pooled prevalence of the PL originating from the left lobe (LL) was established at 40.10% (95% CI: 28.83%–51.92%). In conclusion, we believe that this is the most accurate and up‐to‐date study regarding the complete surgical anatomy of the PL. The PL was prevalent in 42.82% of the cases, being slightly more prevalent in males (40.35%) than females (37.43%). The mean length and width of the PL were 23.09 mm and 10.59 mm, respectively. Our results should be taken into consideration when performing procedures on the thyroid gland, such as thyroidectomies. The presence of the PL can affect the completeness of this procedure and lead to postoperative complications.

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Isolated Papillary Thyroid Carcinoma of the Pyramidal Lobe: A Case Report and Review of Literature

Hage¹,

Medha²,

Balaji³

et al. 2023

Indian J Otolaryngol Head Neck Surg

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Surgical anatomy of the pyramidal lobe in cancer patients: A Prospective Cohort in a Tertiary Centre

Abstract: PL is a well established entity which is present in over one third of patients. Efforts should be made to identify PL during surgery given its bearing on the management of thyroid carcinoma as nearly 10% of these will be site of multifocal papillary carcinoma.

Cited by 6 publications

References 14 publications

Ultrasound for the detection of the pyramidal lobe of the thyroid gland

Ultrasound for the detection of the pyramidal lobe of the thyroid gland

The prevalence and anatomy of the pyramidal lobe of the thyroid gland: A meta‐analysis with implications for thyroid surgery

Isolated Papillary Thyroid Carcinoma of the Pyramidal Lobe: A Case Report and Review of Literature

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