[Thyroid Incidentaloma. Overdiagnosis and Overtreatment of Healthy Persons with Thyroid Illness?]

Overview

Journal Chirurg

Specialty General Surgery

Date 2007 Jul 14

PMID 17628759

Citations 9

Authors

H Dralle

Affiliations

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Abstract

Thyroid incidentalomas have been found in about 20% of cases screened by neck ultrasound, and asymptomatic thyroid cancer is detected in about 10% of autopsies. The incidence of clinically treated thyroid cancer in Germany is increasing without an increase in cancer-specific mortality. Presently the incidence is about 4500 cases per year (7.3/100,000, 3000 females). For early detection and treatment of clinical thyroid cancer ultrasonography-guided fine needle aspiration cytology of suspicious nodules therefore is crucial. Thyroid lobectomy is the treatment of choice for suspicious nodules to lower the risk of morbidity in case of reoperation due to a postoperative diagnosis of cancer. However, subtotal lobectomy may also be justified, especially with nodules in anterior position, because the risk of malignancy is only 3-5%. Frozen selection and/or early final histopathology should be available to avoid two-stage thyroid cancer operations.

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