Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation

Simple item page
dc.contributor.authorCairncross, Lydia
dc.contributor.authorPanieri, Eugenio
dc.date.accessioned2021-10-08T07:17:47Z
dc.date.available2021-10-08T07:17:47Z
dc.date.issued2013
dc.description.abstractAIM: Ultrasonography and fine-needle aspiration biopsy (FNAB) are the mainstays of diagnosing thyroid cancer accurately and reducing the number of diagnostic lobectomies. No benchmark for diagnostic accuracy has been published in the South African context. This single-institution study addresses this deficit. METHODS: The oncology, pathology and surgical records of all patients diagnosed with thyroid carcinoma from 2004 to 2010 at Groote Schuur Hospital, Cape Town, South Africa, were reviewed and data were recorded on a standardised confidential proforma. The findings on pre-operative clinical assessment, ultrasound and FNAB were correlated with the histopathology results. Diagnostic accuracy for thyroid cancer was determined by correlating pre-operative investigations with the final diagnosis. Sensitivity of ultrasound and FNAB were calculated. RESULTS: A total of 109 patients, 79 female and 30 male, were identified. The majority (99, 90.8%) had well-differentiated thyroid cancers (56 papillary, 30 follicular, 10 mixed and 3 Hurtle cell carcinomas). There were 6 anaplastic and 4 medullary carcinomas. Of the 109 patients 38 had a definite pre-operative diagnosis, in 61 a malignant tumour was suspected, and 10 had surgery for benign disease. FNAB was inadequate in 11 cases and the findings indicated a benign lesion in 47, a suspicious lesion in 13 and a malignant lesion in 38 patients diagnosed with thyroid carcinoma. FNAB diagnosed all patients with medullary and anaplastic carcinoma but less than half of those with well-differentiated thyroid carcinoma. Ultrasound scans detected at least one suspicious feature in 44 patients. Microcalcification was the most common sign. CONCLUSION: The rate of pre-operative diagnosis of well-differentiated thyroid carcinomas in this unit is under 50%, well below international norms. Our standard practice needs to change to include ultrasound-guided FNAB and standardised reporting of high-resolution ultrasound and cytology, before reassessment of our diagnostic accuracy.
dc.identifier.apacitationCairncross, L., & Panieri, E. (2013). Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation. <i>South African Journal of Surgery</i>, 51(2), 46 - 177. http://hdl.handle.net/11427/34816en_ZA
dc.identifier.chicagocitationCairncross, Lydia, and Eugenio Panieri "Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation." <i>South African Journal of Surgery</i> 51, 2. (2013): 46 - 177. http://hdl.handle.net/11427/34816en_ZA
dc.identifier.citationCairncross, L. & Panieri, E. 2013. Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation. <i>South African Journal of Surgery.</i> 51(2):46 - 177. http://hdl.handle.net/11427/34816en_ZA
dc.identifier.issn0038-2361
dc.identifier.issn2078-5151
dc.identifier.ris TY - Journal Article AU - Cairncross, Lydia AU - Panieri, Eugenio AB - AIM: Ultrasonography and fine-needle aspiration biopsy (FNAB) are the mainstays of diagnosing thyroid cancer accurately and reducing the number of diagnostic lobectomies. No benchmark for diagnostic accuracy has been published in the South African context. This single-institution study addresses this deficit. METHODS: The oncology, pathology and surgical records of all patients diagnosed with thyroid carcinoma from 2004 to 2010 at Groote Schuur Hospital, Cape Town, South Africa, were reviewed and data were recorded on a standardised confidential proforma. The findings on pre-operative clinical assessment, ultrasound and FNAB were correlated with the histopathology results. Diagnostic accuracy for thyroid cancer was determined by correlating pre-operative investigations with the final diagnosis. Sensitivity of ultrasound and FNAB were calculated. RESULTS: A total of 109 patients, 79 female and 30 male, were identified. The majority (99, 90.8%) had well-differentiated thyroid cancers (56 papillary, 30 follicular, 10 mixed and 3 Hurtle cell carcinomas). There were 6 anaplastic and 4 medullary carcinomas. Of the 109 patients 38 had a definite pre-operative diagnosis, in 61 a malignant tumour was suspected, and 10 had surgery for benign disease. FNAB was inadequate in 11 cases and the findings indicated a benign lesion in 47, a suspicious lesion in 13 and a malignant lesion in 38 patients diagnosed with thyroid carcinoma. FNAB diagnosed all patients with medullary and anaplastic carcinoma but less than half of those with well-differentiated thyroid carcinoma. Ultrasound scans detected at least one suspicious feature in 44 patients. Microcalcification was the most common sign. CONCLUSION: The rate of pre-operative diagnosis of well-differentiated thyroid carcinomas in this unit is under 50%, well below international norms. Our standard practice needs to change to include ultrasound-guided FNAB and standardised reporting of high-resolution ultrasound and cytology, before reassessment of our diagnostic accuracy. DA - 2013 DB - OpenUCT DP - University of Cape Town IS - 2 J1 - South African Journal of Surgery LK - https://open.uct.ac.za PY - 2013 SM - 0038-2361 SM - 2078-5151 T1 - Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation TI - Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation UR - http://hdl.handle.net/11427/34816 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34816
dc.identifier.vancouvercitationCairncross L, Panieri E. Pre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation. South African Journal of Surgery. 2013;51(2):46 - 177. http://hdl.handle.net/11427/34816.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Journal of Surgery
dc.source.journalissue2
dc.source.journalvolume51
dc.source.pagination46 - 177
dc.source.urihttps://dx.doi.org/10.7196/sajs.1261
dc.subject.otherHumans
dc.subject.otherThyroid Neoplasms
dc.subject.otherDiagnosis
dc.subject.otherDifferential
dc.subject.otherBiopsy
dc.subject.otherFine-Needle
dc.subject.otherTreatment Outcome
dc.subject.otherThyroidectomy
dc.subject.otherRisk Factors
dc.subject.otherSensitivity and Specificity
dc.subject.otherRetrospective Studies
dc.subject.otherSouth Africa
dc.subject.otherFemale
dc.subject.otherMale
dc.titlePre-operative diagnosis of thyroid cancer: Clinical, radiological and pathological correlation
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
CairncrossLydia_Pre_operative_d_2013.pdf
Size:
73.68 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles