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ISSN 1405-0099 (Print)

2001, Number 3

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Cir Gen 2001; 23 (3)

Therapeutic decision for a follicular tumor

Hurtado LMN, Zaldivar RFR, Basurto KE

Language: Spanish
References: 17
Page: 145-1147
PDF size: 28.95 Kb.


ABSTRACT

Objective: To determine whether fine needle aspiration biopsy (FNAB) and the transoperative study by freezing (TSF) are reliable to decide to operate and to determine the surgical extension for a follicular tumor.
Setting: Third level health care hospital.
Method: Transversal, retrospective, comparative study during a 5-years period (1993-1998) in patients subjected to surgery to resolve thyroid nodules and in whom “follicular tumor” was reported by either of the diagnostic studies performed (FNAB, TSF) and compared with the definitive histopathologic study.
Results: A total of 61 patients were studied (60 women and 1 man), average age of 40.1 years. From the 26 follicular tumors confirmed by the histopathologic study, four corresponded to follicular cancer (15.4%) and 22 to adenomas (84.6%).
FNAB had a sensitivity of 65%, specificity of 44%, positive predictive value (PV+) of 75% and negative predictive value (PV-) of 33%.
TSF had a sensitivity of 71%, specificity of 4%, PV+ 48%, and PV-11%. Combining FANB and TSF yielded a sensitivity of 60%, specificity of 33%, PV+ 60% and PV-33%.
Conclusion: Discrepancies exist between FNAB/ TSF and the definite histopathologic diagnosis in the presence of a follicular tumor; therefore, for any thyroid nodule diagnosed as “follicular tumor” through FNAB it is advised not to make the TSF and to await for the definite histopathologic diagnosis to norm the action to be taken. If no FNAB is available, but a “follicular tumor” has been diagnosed through TSF, the definite histopathologic diagnosis must be awaited to decide on the final action to be taken.


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