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Objective To investigate the diagnosis, surgical treatment of thyroid cancer and prevention of the surgical complications. Methods Clinical data of 246 cases of thyroid cancer were analysed retrospectively from March 1990 to April 2001. Results 135 and 80 patients were diagnosed before and during operation, and all patients were diagnosed after operation; Reoperation was performed in 57 patients and residual carcinoma tissue was found in 30 patients; 1, 3 and 5 years surviving rate of thyroid cancer after operation were 99.2% , 96.3% and 91.5% respectively; No death occurred in the 246 cases after operation, 4 cases of whom showed temporary vocal cord paralysis and 3 cases showed tic due to hypocalcemia. Conclusions Intraoperative frozen section is helpful for the diagnosis and the choice of operative methods; The extention of thyroidectomy and whether to perform lymph dissection vary with the pathology types and risk factors. Patients should take thyroid tablets all their lives.
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Objective To study the clinical characteristics, surgical treatment and prognosis of thyroid carcinoma in children. Method The clinical data of 25 children with thyroid carcinoma undergoing operative treatment from 1980 to 2001 were analyzed retrospectively. Results 25 children all underwent surgical treatment .Of them,17 were papillary carcinomas,3 papillary carcinomas with follicular elements,3 follicular carcinomas,1 medullary carcinoma and 1 fibrosarcoma. 21 children were followed up periodically from 4 months to 18 years (average time 6years). There were two deaths in the followed-up period,1 died of pulmonary insufficiency in extensive pulmonary and cervical lymph nodes metastases two years after the operation; 1 died of fibrosarcoma recurrence. The other children were all alive in good condition. Conclusions Most of the thyroid carcinoma in children are papillary carcinomas, and the prognosis is usually excellent. Operation is the main therapeutic method. A proper surgical procedure is major approach in treatment. Re-operation is also necessary, and might get a long-term survival even if the patient has recurrent thyroid carcinoma with cervical lymph node metastases.
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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 .