Alamoudi Uthman, Levi Eric, Rigby Matthew H, Taylor S Mark, Trites Jonathan R B, Hart Robert D
Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
OTO Open. 2017 Mar 31;1(1):2473974X17701084. doi: 10.1177/2473974X17701084. eCollection 2017 Jan-Mar.
The incidental thyroid lesion is a common finding during general imaging studies. Their management has been the subject of numerous studies and recommendations. Parathyroid disease workup necessitates imaging investigation of the adjacent thyroid gland and therefore provides a unique window to the perioperative management of thyroid incidentaloma. The specific prevalence of incidental thyroid lesions in the context of parathyroid disease is unknown. We seek to investigate its prevalence during parathyroid workup and surgery and to ascertain if there was a change in management of these patients.
Five-year retrospective database review.
Tertiary care medical center.
The source and indication for referral, preoperative investigation findings, and management of the incidental thyroid lesions were examined. The actual procedure performed and final pathology results were assessed.
A total of 98 patients and 106 operations, including revision surgeries, were identified. There were 21 incidental thyroid lesions (21.4%) detected, whereby 15 patients underwent fine-needle aspirations and 12 subsequently had diagnostic hemithyroidectomies. This decision was made preoperatively in 5 patients and intraoperatively in 7 patients at the time of parathyroid surgery. Along with other pathologies, there were 7 patients with micropapillary thyroid carcinoma identified.
In our series, the prevalence of incidental thyroid lesion and thyroid malignancy is comparable to the general population. The management of the initial parathyroid disease in our patients was altered by the imaging and cytological findings of these thyroid lesions. This has implications on perioperative counseling of the thyroid and parathyroid disease.
甲状腺偶发病变是一般影像学检查中常见的发现。其管理一直是众多研究和建议的主题。甲状旁腺疾病检查需要对邻近的甲状腺进行影像学检查，因此为甲状腺偶发瘤的围手术期管理提供了一个独特的窗口。甲状旁腺疾病背景下甲状腺偶发病变的具体患病率尚不清楚。我们旨在调查其在甲状旁腺检查和手术期间的患病率，并确定这些患者的管理是否有变化。
五年回顾性数据库审查。
三级医疗中心。
检查甲状腺偶发病变的转诊来源和指征、术前检查结果及管理情况。评估实际实施的手术和最终病理结果。
共确定98例患者和106例手术，包括翻修手术。检测到21例甲状腺偶发病变（21.4%），其中15例患者接受了细针穿刺抽吸，12例随后进行了诊断性半甲状腺切除术。5例患者在术前做出该决定，7例患者在甲状旁腺手术时术中做出该决定。除其他病理情况外，确定有7例微小乳头状甲状腺癌患者。
在我们的系列研究中，甲状腺偶发病变和甲状腺恶性肿瘤的患病率与普通人群相当。这些甲状腺病变的影像学和细胞学检查结果改变了我们患者最初甲状旁腺疾病的管理。这对甲状腺和甲状旁腺疾病的围手术期咨询有影响。
