Review analysis of medullary carcinoma thyroid--15-year Indian experience.

To emphasize the importance of adequate primary surgery in cases of medullary carcinoma of the thyroid, 44 cases of treated medullary carcinoma of thyroid were retrospectively reviewed in Government General Hospital, Chennai between 1987 and 2002. Patients who underwent total thyroidectomy with only central compartment dissection were compared with those who had undergone total thyroidectomy with meticulous triple compartment (bilateral lateral and central groups) nodal dissection. The group of total thyroidectomy with only central compartment dissection had high rate of lymph nodal recurrence and persistent hypercalcitoninaemia when compared with the group of total thyroidectomy with meticulous triple compartment nodal dissection. (Chi square value 4.503 with p<0.05).

Surgical treatment of endocrine hypertension experience in India.

Between 1980 and 1994, 162 cases of endocrine based hypertension were diagnosed and treated surgically. Seventy-nine cases (48.7%) of phaeochromocytoma, 63 cases (38.8%) of Cushing's syndrome, and 20 cases (12.3%) of Conn's syndrome were diagnosed. In phaeochromocytoma 75% of the tumours arose from the adrenal glands and 25% arose from the extra-adrenal sites. Cushing's syndrome was caused by adenoma (45%), diffuse bilateral adrenal hyperplasia (36%), pigmented macronodular hyperplasia (9%), and adrenal carcinoma (10%). The most common cause of Conn's syndrome was adenoma (95%) which arose mainly from the left adrenal gland (60%). In the present series the success rate of surgical treatment was 100% for phaeochromocytoma, 90% for Cushing's syndrome and 96% for Conn's syndrome. Trucut biopsy of the kidneys of these patients showed hypertensive changes, the moderate hypertension could be due to renal damage.

Solitary nodule of the thyroid and the role of fine needle aspiration cytology in diagnosis.

In this study the pre-operative diagnostic procedures carried out on 100 patients with clinically solitary nodule of the thyroid experienced over a period of one year with special emphasis on the usefulness of fine needle aspiration biopsy cytology (FNAC) was evaluated retrospectively. All of the 100 patients underwent operation except 2 patients with FNAC diagnosis of Hashimoto's thyroiditis and 7 patients with FNAC diagnosis of colloid goitre. Histopathological study of surgically resected specimens in 91 patients revealed 67 adenomas, one subacute thyroiditis, 3 Hashimoto's thyroiditis, 8 follicular carcinomas, 11 papillary carcinomas and one medullary carcinoma. FNAC tallied in 95% of cases. It was false positive in 2 cases (one case of subacute thyroiditis and one case of Hashimoto's thyroiditis), false negative in one case (a case of follicular carcinoma) and non-diagnostic in 2 cases (2 cases of Hashimoto's thyroiditis).