Surgical management of thyroid follicular neoplasms:A retrospective analysis of 128 patients

Abstract

Aim The most appropriate surgical management of follicular neoplasm/suspicious for follicular neoplasm (FN) lesions is still controversial. The aim of the study is to analyze the outcomes of surgical procedures in the treatment of FN patients.Method We retrospectively evaluated 128 patients, surgically treated after an FN diagnosis. Total thyroidectomy (TT) or hemithyroidectomy (HT) was performed according to the clinical signs of the patients.
The main criteria for HT were a single nodule, nodule size, younger age, and the absence of thyroiditis or clinical/intraoperative suspicion of malignancy. Age, gender, associated thyroiditis, and nodule size were compared along with definitive pathology. Complication rates were also evaluated.Results TT was performed in 87/128 (68%) and HT in 41/128 (32%) patients. Completion thyroidectomy was required in only 6/41 HT patients. The overall malignancy rate was 37/128 (28.9%); 32.4% (12/37 patients) following HT, and 67.6% (25/37 patients) following TT, respectively. No complications were reported in the HT group.Conclusion Considering the low risk of FN lesions, HT is an appropriate method for treatment in selected patients with minimal morbidity. However, in cases of multinodular disease, associating chronic thyroiditis, or a higher risk of cancer, TT should be recommended.

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