Department of Endocrinology and Metabolism, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
Turk J Med Sci. 2020 Feb 13;50(1):8-11. doi: 10.3906/sag-1610-125.
BACKGROUND/AIM: The most appropriate surgical management of follicular neoplasm/suspicious for follicular neoplasm (FN) lesions is still contradictory. We aimed to evaluate the data of our patients with follicular neoplasm treated with thyroidectomy.
We retrospectively analyzed the data of 74 patients who were diagnosed with follicular neoplasm cytology (FN cytology) by fine needle aspiration biopsy (FNAB) and had undergone total thyroidectomy or lobectomy with isthmectomy (LwI).
We examined a total of 74 patients, of which 64 (83.7%) were female and 10 (16.3%) were male. The malignancy rate in the pathological examinations of these patients was 31/74 (41.9%). The most common cancer among the patients with malignancy was papillary thyroid carcinomas (PTC) (20/31, 65%). Among the subtypes of PTCs, 11 were classical PTC, 5 were a follicular variant of PTC, 2 were the oncocytic variant of PTC, 1 was the diffuse sclerosing variant, and 1 was a columnar cell variant of PTC.
Since most FN cytology has been pathologically diagnosed with papillary cancer and some papillary cancer subtypes have been unfavorable pathologically, total thyroidectomy should be the most suitable treatment option in this group. Lobectomy with LwI is not suitable for patients with FNAB-proven FN cytology.
背景/目的：滤泡性肿瘤/疑似滤泡性肿瘤（FN）病变的最佳手术治疗仍存在争议。我们旨在评估经甲状腺切除术治疗的滤泡性肿瘤患者的数据。
我们回顾性分析了 74 例经细针穿刺活检（FNAB）诊断为滤泡性肿瘤细胞学（FN 细胞学）并接受甲状腺全切除术或峡部切除术加对侧叶部分切除术（LwI）的患者的数据。
我们共检查了 74 例患者，其中 64 例（83.7%）为女性，10 例（16.3%）为男性。这些患者的病理检查恶性率为 31/74（41.9%）。恶性患者中最常见的癌症是甲状腺乳头状癌（PTC）（20/31，65%）。在 PTC 的亚型中，11 例为经典 PTC，5 例为 PTC 的滤泡变体，2 例为 PTC 的嗜酸细胞变体，1 例为弥漫性硬化变体，1 例为 PTC 的柱状细胞变体。
由于大多数 FN 细胞学已在病理上诊断为乳头状癌，而某些乳头状癌亚型在病理上预后不良，因此甲状腺全切除术应是该组患者最适合的治疗选择。对于 FNAB 证实为 FN 细胞学的患者，不适合行 LwI 加对侧叶部分切除术。
