2018, Number 2
Rev Cuba Endoc 2018; 29 (2)
Clinical, ultrasonographic and cytohistological diagnosis of differentiated thyroid carcinoma
Bustillo SE, Naranjo GMC, Rivero AM, Bustillo ME
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ABSTRACTIntroduction: differentiated thyroid carcinoma represents the most frequent malignant neoplasia in Endocrinology. Its clinical presentation and diagnosis have been modified thanks to the availability of diagnostic tools, such as thyroid ultrasound and fine needle aspiration biopsy.
Objectives: to describe the clinical, ultrasonographic and cytohistological characteristics of patients undergoing surgery for malignant thyroid disease, and to evaluate in them the prevalence of chronic hypocalcemia and the value of the thyroid´s stimulating hormone.
Methods: a retrospective descriptive study was carried out, in which consecutive reports of Pathological Anatomy of all patients surgically treated for nodular thyroid disease at "Camilo Cienfuegos" Provincial General Hospital in the period from January 2012 to December 2014 were reviewed. The sample consisted of 118 medical records of patients operated on for nodular-thyroid disease that met the following criteria: clinical data, results according to the Bethesda criteria of fine needle aspiration, thyroid ultrasound and biopsy. These patients were called for a clinical evaluation and they were indicated to be fasting. The patients were classified into carriers of: ETM (n=. 39) and benign thyroid disease (n= 79).
Results: in clinical terms, only 15.4 % of the patients with malignant thyroid disease presented spontaneous pain or discomfort, and / or during palpation of the thyroid glands. Malignant thyroid disease was diagnosed in all categories of cytodiagnosis: I: 1/1 (100 %), II: 8/83 (9.6 %), III: 4/6 (66.7 %), IV: 2/2 (100 %), V: 18/20 (90 %), VI: 6/6 (100 %). Papillary carcinoma represented the most frequently diagnosed neoplasm (37/39 patients); 33.3 % of these patients showed thyroid stimulating hormone levels above 2.0 mU/L, and there was 46.15 % of chronic hypocalcemia.
Conclusions: papillary carcinoma was the most frequently diagnosed neoplasm in patients operated of malignant thyroid disease. The majority of these patients had a subclinical behavior, a third of non-optimal values of the thyroid stimulating hormone and a high prevalence of chronic hypocalcemia.