The enucleation of thyroid tumors indeterminate before surgery as papillary thyroid carcinoma: should immediate reoperation be performed?

The management of patients with thyroid nodules which are indeterminate as papillary thyroid carcinoma (PTC) before surgery but identified as such after surgery still poses great difficulty for the surgeon. Immediate reoperation is often not performed due to the indolent biological characteristics of this disease and the increased risk of associated surgical complications. We conducted a study to determine whether or not immediate reoperation should be performed. The prognosis of 91 patients with PTC who underwent enucleation only was compared with that of 321 control patients with non-advanced PTC who underwent radical surgery during the same period. There were no deaths due to PTC in either group. Distant metastasis was observed in 1.1% and 0.6% of the enucleation and control patients, respectively, while local recurrence was observed in 3.3% and 8.1%, respectively. These results suggest that immediate reoperation is not necessary for patients who have undergone enucleation only.