Diagnostic aspects in 117 patients treated surgically for thyroid carcinoma.

A series of 117 patients operated on for thyroid carcinoma from 1969-1973 is compared with a previous series of 115 cases treated from 1956-1968, with the object of clarifying diagnostic aspects and indications for primary operation. In the group with papillary carcinomas there was a high peak of incidence among young patients both females and males aged 20 to 30 years. In the present series the incidence of metastases was less than in the previous series. Lymph node metastases in the neck were the only metastases in papillary and medullary carcinomas. The time interval between beginning of treatment and appearance of main symptoms had decreased noticeably. The pre- and peroperative diagnostic procedures employed made it possible to operate as the primary procedure in 78% of papillary, 100% medullary and 86% anaplastic tumours, but only in 52% of follicular carcinomas. The most common reason for diagnostic failure was that frozen section had not been performed during the primary operation. The value of both aspiration biopsy and frozen section was dependent on the histological type of the tumour; it was more reliable in papillary and anaplastic than in follicular carcinomas. The operability rate had not changed essentially, 94% of papillary and 85% of follicular, but only 24% of anaplastic primary tumours could be radically removed. The value of establishing a firm diagnosis is to be able to operate as a primary procedure in these tumours when less operative complications occur.