Endocrine Abstracts

We retrospectively analyzed case reports of patients been operated within 50 yrs. Our investigation demonstrates increasing tendency of TC. Total frequency of TC has increased from 0.76% in 1953–1964 to 8.48% in 2001–2005. Analysis revealed prevalence of TC in women (87.6%), sharp increase of morbidity after 30 years (14.6%), peak of morbidity – after 60 years (27.4%). Frequency of TC among adolescents is not increased (1.6–2.3%) that’s associated with relative prosperity on pollution with iodine isotopes. TC is more frequent in town-dwellers (72.2%) due to higher pollution of environment that’s a factors of thyroid hyperplasia.

Analysis of CT morphology demonstrates prevalence of differentiated forms: papillary (24.9%), follicular (15.5%), papillary-follicular (20.4%), microcarcinoma is revealed in 32%, medullary - in 4.5%, anapl?stic - in 1.9%, non-epithelial tumors - 0.8%.

We occupy active position for treatment of thyroid nodes, especially in doubtful cytological results, elderly women, children/adolescents, after radiation in the past.

Thyroid surgery isn’t indifferent to patients. Baseless thyroidectomy worsens life quality (constant replacement therapy, intensifies accompanying diseases, provides background for other tumors), increases risk of complications. Therefore in differentiated TC we prefer sparing surgery – hemithyroidectomy, resection of isthmus & medial part of another lobe. Thyroidectomy and fat dissection is indicated in non-differentiated TC if tumor is extended out one lobe, multifocal growth in both lobes, distant metastases before iodine-therapy. Crile’s operation is performed if TC proliferates into sternocleidomastoid muscle/internal jugular vein.

Conclusions: 1. Thyroid surgery must be provided in specialized clinics.

2. Differentiated TC is indication for sparing surgery. Thyroidectomy must be adequately based.

All thyroid nodes should be operated with following histological identification and adequate post-surgery management.