2012, Number S5
PDF size: 92.44 Kb.
ABSTRACTIntroduction: the thyroid carcinoma is characterized by low incidence, low malignant behaviour as well as low mortality. The most of they are developed from multinodular goitres of long duration so is important to be into account the risk factors such as: time of the establishment of the disease, size and the particular and personal characterists and the evolution of the each case. If we take into account the great technological advance of the BAAF from its performance in the past century to be united to the National Health System of our country ,we have to say that the multinodular goitres in any group of age are easily manageable and accessible which may us to avoid the malignant transformation besides we can do that the life continues with the quality humanely requested . Finally, this is the first goal of the Cuban Public Health.
Objective: to highlight the importance of an appropriate follow-up of multinodular goitre as a significant element in the prevention of its multinodular malignant transformation.
Case presentation: an 80 year- old, female patient presents an increase of the volumen of the anterior section of the neck, with pathologic antecedents of a multinodular goitre which the evolution has been characterized by an irregular and non systematic treatment along of years .She could have better quality of life as well as to avoid to death taking into account the wild conditions of that disease was presented herself. Physical examination: It has been observed an increase of the anterior area of the neck. On palpation ,it was felt a mass of irregular surface, painful and of a hard consistency with 6x5cms. approximately that had increased notably in the course of the last months. On the admission, the patient presented a serious respiratory process and poor general status so we only achieved a Fine Needle Aspirative Biopsy (FAAB).She continuos with reapiratory compromised so a surgical racheotomy was ejecuted that only help her as a way of supporting in the patient terminal stage in this malignant disease (Anaplastic Carcinoma of Thyroid). Despite the recommended procedure the patient died. The family accepted the autopsy.
Conclusions: the multinodular goitres have to exam periodically in order to just may to do the tiroidectomy as the preventive measure in benign diseases of thyroid and avoid the malignant changes that could occurred when the gland is irradiated.The tiroidectomy ejecuted at just time avoid the malignant transformation as well as the metastasis in Anaplastic Carcinoma Thyroid.
Thomusch O, Sekulla C, Dralle H. Is primary total thyroidectomy justified in benign multinodular goiter? Chirurg. 2003; 74 (5): 437-43.
Chiacchio S, Lorenzoni A, Boni G, Rubello D, Elisei R, Mariani G. Anaplastic thyroid cancer: prevalence, diagnosis and treatment. Minerva Endocrinol. 2008; 33 (4): 341-57.
Rozhl Chir. Total thyroidectomy in malignant goiter, significance and problems. 2002;1(1):5-7.
Agarwal G, Aggarwal V. Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? An evidence-based review.World J Surg. 2008;32(7):1313-24.
Paksoy M, Aydýn S, Ayduran E, Eken M, Sanlý A, Taþdemir O. Clinical signs and management strategies in thyroid masses. Kulak Burun Bogaz Ihtis Derg. 2008;18 (5):294-299.
Sequeiros G, Llorente JL, Rodrigo JP, Puente M, Suárez C. Carcinoma anaplásico de tiroides. Nuestra experiencia. Investigación clínica. Acta Otorrinolaringol Esp. 2004; 55: 424-429.
Espín Andrade AM. Familia y vejez, en salud para la vida: Un sitio cubano para cultivar salud. 2005. Disponible en: www.saludparalavida.sld.cu (Visitado Febrero 2012).
Moons P, Budas W, De Geest S. Critique on the conceptualisation of quality of life :a review and evaluation of different conceptual approaches. Int J Nurs Stud. 2006; 43 (7): 891-901.
Tomes Pérez HE, GutiérrezHermosillo H, Forsbach Sánchez G, Gómez de Ossío MD, González González G, Guzmán López S.Non-diganostic thyroid fine needle aspiration cytology:outcome in surgical treatment. Citology; 2007;59(3):926-31.
Smallridge RC, Copland JA. Anaplastic thyroid carcinoma: pathogenesis and emerging therapies.Clin Oncol (R Coll Radiol). 2010;22 (6):486-97.
García Fernández E, Requejo Salinas H, Azriel Mira S,Hawkins Carranza F.Transformation anaplásica tardía de 2 bocios multinodulares. Revi endocrinol y nutri; 2006; 3(9):515-8.
Zivaljevic V, Vlajinac H, Jankovic Marinkovic J, Diklic PaunovicI A. Casecontrol study of anaplastic thyroid cancer. Tumori. 2004;90:9-12.
Moalem J, Suh I, Duh QY. Treatment and prevention of recurrence of multinodular goiter: an evidence-based review of the literature.-World J Surg.2008; 32 (7):1301-12.
Domínguez Alonso E, Seuc Jo A. Esperanza de vida ajustada para algunas enfermedades crónicas no transmisibles. Revista Cubana Higiene y Epid.2005; 43(2 ):0.