ABSTRACT
Objective To investigate the diagnosis and treatment of hashimoto′s disease(HD) complicated with thyroid adenomas(TA).Methods Clinical data of 50 cases of HD complicated with TA were analysed retrospectively. Results 8 patients were diagnosed before operation ,misdiagnosis rate was 84.0%.Intra operation frozen section diagnosis rate was 81.4% (35/43).All patients were diagnosed as HD complicated with TA by pathology after operation.Various extension thyroidectomies were performed according to the patients conditions. After operation,27 cases were given small dosage of thyroxine and 2 cases were given small dosage of prednisone. All the 50 patients were followed up for 3 months to 1 year, none presented hypothyroidism.Conclusions Complete serum immunologic examinations,ultrasonography and fine needle aspiration biopsy are helpful for the diagnosis of HD with TA. HD with TA should be treated surgically,and the intraoperation frozen section for the diagnosis is important.The operation procedures,extension of excision and medication after operation should be individulization to avoid the occurrence of postoperative hypothyroidism as possible.
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Objective To study the diagnosis and indications of operation of thyroiditis associated with thyroid cancer(TTATC). Methods The clinical data of 16 patients with TTATC were analysed retrospectively. Results All 16 patients were treated surgically, including subacute thyroditis with thyroid cancer in 4 patients, Hashimoto's disease with thyroid cancer in 12. The carcinoma of thyroid were composed of 12 papillary, 3 follicular, and 1 mixed papillary follicular cancer. The 16 patients were followed up for 2 months 9 years, showing they were all alive and healthy. Conclusions In order to avoid delaying the treatment of thyroid cancer, the following thyroiditis with thyroid nodule should be operated earlier: (1) The nodule in thyroditis didn't alter to smaller and shows a tendency to be enlarge after systematic drug therapy. (2) the cold nodule is of cold character in SPECT but solid in ultrasound.
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Objective To investigate the diagnosis and surgical management of Hashimoto's thyroiditis and coexisting disease. Methods The clinical data of 54 patients with Hashimoto's thyroiditis were analyzed retrospectively. Results 25 cases were diagnosed as Hashimoto's disease by clinical physical examination, FNAB and immune antibody assay. Diagnostic treatment with medicine was adopted firstly. Of them 24 cured, one was found coexisting thyroid cancer, and then a radical operation was performed. The other 29 cases had been misdiagnosed as surgical diseases because of atypical features and undergoing thyroidectomy; the diagnosis of Hashimoto's disease had been confirmed by pathology, and some coexistence had been found(hyperthyroidism in 3, thyroid carcinoma in 4, malignant lymphoma in 2, thyroid adenoma in 5). Conclusions Attention should be paid to the atypical Hashimoto's disease. FNAB, immune antibody assay, diagnostic treatment, operative exploration and biopsy would be helpful to make the sound diagnoses of Hashimoto thyroiditis and the disease in coexistence, which ought to be operated on corresopondingly.
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Objective To investigate the relationship between nodular goiter and thyroid cancer and the causes of postoperative recurrence in patients with nodular goiter(NG) undergoing operative treatment. Methods The clinical date of 199 cases of NG were retrospectively analysed. Results Pathological examination revealed that 7 cases were accompanied by thyroid cancer including 2 micro-cancer, all the 7 cases were papillary carcinomas. The postoperative recurrent rate of NG was 11.5%(18 cases).Thyroid nodule reccurrence rate in patients received - operative thyroxin replacement therapy was significantly lower than that in patients not received thyroxin therapy( P
ABSTRACT
Objective To study the diagnosis and treatment of hyperthyroidism companied with thyroid carcinoma . Methods The clinical data of 11 cases of hyperthyroidism with thyroid carcinoma were retrospectively analysed. Results 9 of 11 cases were diagnosed preoperatively,and comfirmed by frozen section intra-operatively and underwent suitable operation. In the other two cases the final diagnosis was made by pathological examination postoperatively, and re-operation was performed on 1 case . All the patients were followed up for 1～16 years and neither hyperthyroidism nor thyroid carcinoma recurred. Conclusion It is difficult to make diagnosis of hyperthyroidism with thyroid carcinoma preoperatively. B mode ultrasonography may find some nodes in enlarged thyroid; but fine needle aspisation biopsg(FNA) has high false negative diagnostic rate. Intra-operative frozen section examination is important in the diagnosis of hyperthyroidism with thyroid carcinoma .