Negative Fine-Needle Aspiration in Patients with Goiter: Should We Doubt It?

World Journal of Surgery
Michal MekelHaggi Mazeh

Abstract

Epidemiologic studies demonstrated higher incidence of thyroid cancer in patients with multinodular goiters compared to the general population. The aim of this study was to evaluate the risk of finding significant thyroid cancer in patients undergoing thyroidectomy for presumed benign disease. The records of 273 patients operated for indications other than cancer or indeterminate cytology were reviewed and analyzed. 202 (74%) patients had a preoperative fine-needle aspiration (FNA) performed. FNA was benign in 96% of patients and non-diagnostic in 4%. Malignancy was unexpectedly found in 50 (19%) patients. Papillary carcinoma constituted 94% of cancers and 86% of cancers were incidental microcarcinomas. Only 7 (2.6%) patients of the entire cohort had tumors greater than 1 cm, of those only 3 had a previous benign FNA (false-negative rate 1.5%). The rate of significant thyroid cancer found unexpectedly in resected goiters is extremely low. A negative FNA excludes significant cancer with near certainty.

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Citations

Oct 19, 2017·Nuklearmedizin. Nuclear Medicine·Philipp Seifert, Martin Freesmeyer
Jun 14, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Martin FreesmeyerPhilipp Seifert
Jul 10, 2017·Langenbeck's Archives of Surgery·Sohail BakkarPaolo Miccoli

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