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Detection Rate of Thyroid Papillary Micro-carcinoma in Multinodular Goiter Surgery.

OBJECTIVE
To determine the frequency of papillary thyroid micro-carcinoma (PTMC) in multinodular goiter (MNG) surgery, as well as in opposite thyroid lobule of the dominant nodule.


STUDY DESIGN
Descriptive study.


PLACE AND DURATION OF STUDY
General Surgery Department, Abant Izzet Baysal University Hospital, between January 2010 and December 2016.


METHODOLOGY
The data of 1300 patients who underwent thyroidectomy analyzed. Patients with single nodule in preoperative sonography, and patients with malignancy or suspected malignancy in fine needle aspiration cytology were excluded. PTMC was labelled as less than 10 mm in diameter.


RESULTS
After exclusion of such patients, 1,197 subjects with benign MNG were included in the study. There were 1,134 patients in benign group and 63 subjects in PTMC group, according to the postoperative pathology results. In PTMC group, 53 (84%) of subjects had one tumor and 10 (16%) has more than one cancerous nodules. Thirty-six (57%) of cancers in PTMC group were right sided and 27 (43%) were left sided. Cancer and dominant nodule were in the same thyroid lobe in 62% (n = 39) subjects in PTMC group. However, 24 subjects had cancer in the lobe opposite to the largest nodule.


CONCLUSION
Total bilateral thyroidectomy should be preferred in MNG surgery due to high probability of multicentric disease.