The neoplastic goitre

Nixon, Iain J.; Simó, Ricard

doi:10.1097/moo.0b013e32835cec37

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…Several assumptions led to this widely shared behavior. The major reasons included the following: low complication rate associated with TT (as reported by several authors) [27][28][29], risk of relapse after hemithyroidectomy [5,7], risk of an occult malignancy [30] that makes follow-up complex, and/or greater difficulty in performing the revision surgery after thyroid lobectomy. Several recent studies have emphasized various advantages of hemithyroidectomy [31,32] in selected cases of malignancy [33,34].…”

Section: Discussionmentioning

confidence: 99%

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Scerrino¹,

Raspanti²,

Attard³

et al. 2017

Langenbecks Arch Surg

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Purpose Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. Methods A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre-and postoperative thyroid hormone levels, and BMI outside the normal range. Demographics; smoking and alcoholism addiction; cardiac, pulmonary, renal, and hepatic failure; diabetes; anxiety; and depression were recorded. The Brief Fatigue Inventory (BFI) was used to evaluate CA and its possible association with these comorbidities 6 and 12 months after thyroidectomy. Results One hundred seventy-seven patients underwent total thyroidectomy (TT), 54 hemithyroidectomy (HT). Thirty-two patients were not recorded because of the onset of exclusion criteria. In the 6 months after thyroidectomy, in the TT group, 64 patients (36.16%) reported an impairment in the BFI score and only 1 in the TL group. The mean BFI score changed from 1.663(±1.191) to 2.16 (±11.148) in the TT group, from 1.584 (±1.371) to 1.171 (±1.093) in the TL group (p < 0.001). No further significant variations in BFI were reported 1 year after surgery. Conclusions CA worsened after TT, but not after HT. Apart from operative procedure itself, no other risk factor was found be significantly associated with post-thyroidectomy asthenia. Further investigation is needed to determine the causes of CA.

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Section: Discussionmentioning

confidence: 99%

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Scerrino¹,

Raspanti²,

Attard³

et al. 2017

Langenbecks Arch Surg

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“…Surgery is the treatment of choice for symptomatic ITG (dyspnea, dysphagia or superior vena cava syndrome) [8], since (1) radioactive iodine ablation (RIA) implies a possible acute reaction causing airway obstruction, (2) most ITG tend to grow, (3) up to 25% of ITG contain malignant disease [2] and (4) up to 90% of ITG can be safely excised via a transcervical approach [9,10]. Some authors argue the need for surgical intervention in asymptomatic patients with incidentally diagnosed goitres during other investigations, especially in elderly individuals or significant co-morbid patients [11].…”

Section: Current Indications For Surgerymentioning

confidence: 99%

“…MNG may present to the surgeon for diagnostic and therapeutic purposes. Classic indications for surgery in these patients include pressure effects and cosmesis, a recognised risk of malignancy, and intrathoracic extension [2].…”

Section: Introductionmentioning

confidence: 99%

Surgical management of intrathoracic goitres

Simó

Nixon

Poorten

et al. 2018

Eur Arch Otorhinolaryngol

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Background Intrathoracic goitres (ITG) often present with compressive symptoms and require specialised care by experienced surgical teams. Most ITG can be accessed by a transcervical approach (TCA) and only between 1 and 15% will require an extracervical approach (ECA). Many controversies exist regarding the clinical presentation, evaluation, selection of cases for ECA, surgical technique and outcomes. This paper reviews the recent literature on the management, outcomes and evidence-based treatment strategies of ITG. Methods We conducted a review of the literature on the evaluation, management and outcomes of surgery for ITGs. Results The incidence of cancer in the ITGs ranges between 4 and 20%. Multiplanar CT scanning offers the best preoperative evaluation and aids to determine the approach. Most ITG can be accessed by TCA and ECA are only needed in maximum 15% of cases. In experienced hands, the outcome of these surgeries is comparable to thyroid surgery for non-ITG. Conclusions Surgery for ITG is challenging. The experienced surgeon however, with few exceptions can address ITG via TCA, with outcomes comparable to those of uncomplicated thyroid surgery.

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“…In cases where FNAC were conducted and proven to be benign in patients with non-functional, cervical MNG the incidental thyroid cancer discovered at the time of thyroidectomy can be as high as 23% [5]. Male gender tends to be associated with an increased likelihood of cancer on final pathology [5, 7]. …”

Section: Discussionmentioning

confidence: 99%

Follicular thyroid carcinoma presenting with pathological fracture of the humerus at initial diagnosis

et al. 2017

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Differentiated carcinomas of the thyroid gland usually have a good prognosis with prognosis often discussed in terms of 20 year survival. Nevertheless its 10-year-survival rate decreases when accompanied by distant metastasis. Follicular thyroid cancer (FTC) is the second most common thyroid cancer and usually presents with a solitary thyroid nodule with or without cervical lymphadenopathy. Distance metastasis at initial diagnosis is seldom observed with incidence range from 1 to 9%. In cases of bone metastasis, the incidence is only 2–3% and weight-bearing skeleton is preferentially affected. In our case, we present a patient with FTC that metastasized to the upper limb causing severe pain and pathological fracture at the initial presentation.

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The neoplastic goitre

Abstract: An increasing number of patients with MNG will be encountered in surgical practice. Most patients can be cured with total lobectomy or total thyroidectomy, which minimizes recurrence rates and ensures an oncological approach to patients with incidentally discovered malignancy within MNG.

Cited by 13 publications

References 27 publications

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Surgical management of intrathoracic goitres

Follicular thyroid carcinoma presenting with pathological fracture of the humerus at initial diagnosis

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