Thyroid Cancer | Chapter 14 | Current Practice in Medical Science Vol. 6

There are two types of thyroid tumours: those that develop from parafollicular cells and those that develop from follicular cells (C cells). Papillary carcinoma, follicular carcinoma, oncocytic cell carcinoma (Hürthle), weakly differentiated carcinoma, and anaplastic carcinoma are examples of differentiated thyroid cancer, which develops from follicular cells. By the year 2022, it is anticipated that there will be 43,800 instances of thyroid cancer in the United States of America, since the incidence has been steadily rising. The majority of instances of this neoplasm, which is classified as the most frequent endocrine tumour and accounts for about 3 percent of all malignant tumours in humans, occur in women in 75 percent of cases, and in people under 55 in 60 percent of cases. The conventional one-size-fits-all strategy to differentiated thyroid cancer has to be reevaluated in light of the rise in the prevalence and incidence of low-risk thyroid cancer during the past 10 to 20 years. This shift to a more customised approach to treating thyroid cancer patients has produced a diagnosis, initial treatment, adjuvant therapy, and follow-up strategy for patients with differentiated thyroid cancer that is considerably more risk-adapted. In this research, evidence-based medicine is used to review current knowledge regarding the clinical presentation, diagnostic process, and treatment of thyroid cancer.

 

Author (s) Details

Fernando Cordera

Sociedad Quirúrgica S.C., American British Cowdray Medical Center, Mexico City, Mexico.

Rodrigo Arrangoiz

Mount Sinai Medical Center, Columbia University, Miami, FL, USA.

 

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Determining the Value of Intra-Operative Frozen Section in Thyroid Neoplasm Management | Chapter 12 | New Horizons in Medicine and Medical Research Vol. 4

 The purpose of this study is to evaluate the value of the frozen section (FS) in the management of patients with thyroid disease, as well as to share our personal experiences with it after thyroid surgery.

In this retrospective investigation, the outcomes of 1110 frozen sections of thyroid tissues analysed during a ten-year period from 2003 to 2012, as well as their linkages with the final histological evaluation, were examined. Deferred replies were not taken into account in statistical calculations.

Results: In our investigation, FS and the final histological diagnosis concurred in 85.4 percent of patients, whereas 5.5 percent differed. 9.1% of the cases were placed on hold. The global specificity and sensitivity of FS analysis were 99.3 percent and 64.7 percent, respectively, for all histological subtypes. It detected papillary cancer with a 61.7 percent sensitivity, follicular carcinoma with an 83.3 percent sensitivity, and anaplastic carcinoma with a 100 percent sensitivity. The disparities were caused by six false-positive (FP) diagnoses and 55 false-negative (FN) diagnoses. Fifty percent of the FN was papillary microcarcinoma. The FS exam has a positive predictive value (PPV) of 94.4 percent and a negative predictive value of 93.9 percent (NPV).

Conclusions: The utility of intraoperative FS in the confirmation of thyroid nodule malignancy is supported by our findings. It's associated with good specificity and a reasonable sensitivity rate. The majority of the inconsistencies between FS and ultimate histological diagnosis were explained by papillary microcarcinoma. Pathologists and surgeons could benefit from a standardised language in their evaluations and decision-making in the operating room.


Author(S) Details

Nihed Abdessayed
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Raja Jouini
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Wafa Koubba-Mahjoub
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Ehsen ben Brahim
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Achraf Chadli Debbiche
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

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