J.Jpn. Surg. Soc.. 87(5): 558-563, 1986

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Original article

REEVALUATION OF SURGICAL TREATMENT FOR THE THYROID NODULES DIAGNOSED AS CANCER POSTOPERATIVELY

Reevaluation was carried out on the surgical treatment for clinically benign thyroid nodules. One hundred and thirty-seven patients underwent conservative resections of the thyroid because of preopeative impression of benign nodules at the First Department of Surgery, Nagoya University Hospital from 1970 to 1984.
Permanent paraffin sections of the resected specimen revealed that the nodules in 4 patients were intrathyroidal cancer (3 papillary and 1 follicular) and the nodules in the other 8 patients were associated with an unsuspected small (3～15mm) thyroid cancer.
All those patients underwent either lobectomy or subtotal thyroidectomy at the initial surgery except for one patient in whom enucleation was performed. No further intervention was carried out when the definitive diagnosis was made, except for one patient in whom the enucleation was followed by lobectomy. No neck dissection was attemped in all of them. patients have been living and well without evidence of recurrence for 3 to 11 years and one died of unrelated disease.
From these results, it is recommended that lobectomy is the least requirement in treating clinically benign nodule and that, when paraffin section reveals the tumor is intrathyroidal cancer, no further surgery is justified unless there are other foci of cancer in the resected lobe.

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