Article ; Online: Do extremely large goiters carry a higher risk of malignancy or complications? A case control study.
American journal of otolaryngology
2024 Volume 45, Issue 4, Page(s) 104283
Abstract: Introduction: The definition of thyroid goiter remains ambiguous, yet size may impact both malignancy rate and surgical complications' rate.: Methods: All patients with thyroid goiter who underwent thyroidectomy between 1/2015-1/2023 were included. ... ...
| Abstract | Introduction: The definition of thyroid goiter remains ambiguous, yet size may impact both malignancy rate and surgical complications' rate. Methods: All patients with thyroid goiter who underwent thyroidectomy between 1/2015-1/2023 were included. Goiter was defined as lobe ≥4 cm. For analysis purpose, goiters measuring 4-8 cm and ≥8 cm were defined as large and extremely large goiters, respectively. For malignancy definition, tumor<1 cm in their largest diameter were excluded from study. Collected data included demographics, cytology, histology and postoperative complication. Results: 144 goiters from 111 patients were included. The most common indication for surgery was symptoms (55 %). Compared with large goiter, extremely large goiters demonstrated a trend for tracheal narrowing on pre-operative CT findings (23 % vs. 45 %, p = 0.07 respectively). Overall differentiated thyroid carcinoma (DTC) rate was 17 % (25/144) without statistical difference between groups (p = 0.89). Within goiters with pre-operative benign cytology, the DTC rate was 17 % (7/43). Follicular variant of papillary thyroid cancer was the most common type for both groups. Nodular hyperplasia was significantly associated with extremely large goiters (53 % vs. 73 %, p = 0.03). No significant difference was found in transient hypocalcemia (48 % [15/31] vs. 41 % [5/12], p = 0.6) and other complications' rate between extremely large goiters and the control group. Conclusion: When discussing management options for patients with goiters, the size of the goiter should not regarded as a higher risk for complications or malignancy, yet the relatively high malignancy rate found should be taken under consideration for resection. |
|---|---|
| Language | English |
| Publishing date | 2024-04-03 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 604541-8 |
| ISSN | 1532-818X ; 0196-0709 |
| ISSN (online) | 1532-818X |
| ISSN | 0196-0709 |
| DOI | 10.1016/j.amjoto.2024.104283 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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