Endocrine Abstracts

Introduction: Reoperative surgery for thyroid disease is rare. It is sometimes indicated for nodular recurrence after partial surgery for initially benign thyroid disease or for a completion total thyroidectomy when a final diagnosis of thyroid cancer is confirmed on a permanent section of a partially removed thyroid gland. We aimed to investigate the demographic features and reoperation indications in patients with reoperative thyroidectomy.

Methods: Thirty-six patients reoperated between 2008 and 2011 were included into the study. Demographic features, indications of reoperation and histopathological results of patients were evaluated retrospectively.

Results: After reoperative thyroidectomy, the results of histopathological evaluation of 24 patients were malignant (19 papillary thyroid carcinomas, three follicular thyroid carcinomas, one Hurthle cell neoplasm and one neoplasm with undetermined malignant potential) while 12 patients were benign. Of 36 patients, 11 (30.5%) went to reoperation due to giant thyroid nodule (>4 cm), 5 (13.9%) due to ≥2 nondiagnostic fine needle aspiration biopsy (FNAB), 3 (8.3%) due to toxic multinodular goitre, 5 (13.9%) due to malignant cytology, 2 (5.6%) due to suspected malignancy, 2 (5.6%) due to suspicion for a follicular neoplasm, 3 (8.3%) due to follicular lesion of undetermined significance, 1 (2.8%) due to atypia of undetermined significance, 1 (2.8%) due to suspected Hurthle cell neoplasm and 3 (8.3%) due to cytology of cellular adenomatoid nodule and ultrasonography suggesting malignancy.

Conclusion: Thyroid surgery may lead to regional scars and some degree of fibrotic process. This may result in problems in collecting thyroid FNAB samples and assessing cellular abnormalities. Our study findings demonstrated that histopathological evaluation of 14 patients whose cytological results showed no malignancy, was consistent with malignancy. We consider that decision for reoperative thyroidectomy should not be made with cytological findings, but patients’ symptoms and ultrasound findings should also be taken into account.