Surgical management and prognosis of thyroid carcinomas invading adjacent structures

Objectives: To evaluate the surgical approaches and prognosis of thyroid carcinomas invading the adjacent structures

Methods: The medical records of 197 patients with a pathology diagnosis of thyroid cancer were retrospectively reviewed

Results: Seventeen patients [9%] with thyroid carcinoma invading surrounding structures were included. Patients were initially divided into two groups on the basis of tumor histology: papillary [Group A] and nonpapillary [Group B]. Then patients were divided into three groups Group 1: patients who underwent total thyroidectomy Group 2: patients who underwent total thyroidectomy with shaving resection Group 3: patients who underwent total thyroidectomy with extensive surgery. All patients who didn't survive were more than 45 years old. The survival rate was statistically better in group A compared to group B [92% versus 20%]. The survival rate decreased from Group 1 through Group 3, without reaching statistical significance

Conclusions: Age and histologic type are important in determining the prognosis of locally invading thyroid cancer

Parotid tumors: is surgery always the only way?

To analyze the characteristics and management of parotid tumors in a tertiary care center

Study design: Retrospective cohort study

Methods: All cases of parotid tumors [or masses] in our department between Jan 1, 1999 and December 31[st], 2012 were studied. Demographic data, clinical characteristics, histopathology and management were analyzed. We also evaluated the diagnostic value of fine needle aspiration cytology [FNAC] in our center

Results: Of the 216 parotid tumors, 164 underwent parotidectomy and 52 were not managed surgically; 73.1% had a benign tumor [36.6% had Warthin's tumor] and 16.7% had a malignant one. In our center, FNAC was found to have a sensitivity for reporting malignancy of 71.4% and a specificity to rule in malignancy of 100%

Conclusion: In our series, Warthin's tumor was the most frequent mass probably related to the high tobacco use. The prevalence of malignant tumors was relatively high in our series. Primary malignant tumors and pleomorphic adenomas should always be treated surgically, however, lymphomas, metastatic and benign inflammatory masses and cases of Warthin's tumors could be managed nonsurgically