Occult invasion of sternothyroid muscle by differentiated thyroid cancer
| Autor: | Natarajan Sumathi, Zubair Khan, Muthuswamy Dhiwakar, Sangita Mehta |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty medicine.medical_treatment Malignancy Gastroenterology 03 medical and health sciences 0302 clinical medicine Neck Muscles Internal medicine medicine Carcinoma Humans Neoplasm Invasiveness Thyroid Neoplasms 030223 otorhinolaryngology Thyroid cancer Retrospective Studies business.industry Incidence (epidemiology) Thyroid Sternothyroid muscle Thyroidectomy General Medicine Middle Aged medicine.disease Occult medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Female business |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 275(1) |
| ISSN: | 1434-4726 |
| Popis: | To determine the incidence of occult invasion of sternothyroid by differentiated thyroid cancer (DTC) and identify clinico-pathological features associated with the same. Retrospective study of a consecutive series of DTC patients undergoing surgery, with preoperative ultrasound showing no evidence of strap muscle invasion. All had en bloc excision of sternothyroid muscle along with thyroidectomy. Incidence of microscopic invasion of sternothyroid and clinicopathologic features associated with the same, were studied. A total of 76 patients with DTC (2010–2014) were identified, of whom 62 met the inclusion criteria and were included in this study. Of these, 22 (36%) had no extrathyroidal extension (ETE), 30 (48%) had minimal ETE without sternothyroid invasion and 10 (16%) had minimal ETE with microscopic sternothyroid invasion. The mean tumor sizes of the three sub-groups were 1.9, 3.1 and 4.9 cm, respectively, with a significant difference between no ETE and sternothyroid invaded sub-groups (p = 0.03). Out of the 40 cases with minimal ETE, 3 (7.5%) had positive tumor microscopic margin. Retaining sternothyroid in situ would have theoretically increased this proportion to 27.5%. Over a median follow-up of 52 months, 58 (94%) patients remained structurally disease free, with only 1 local recurrence. Occult invasion of sternothyroid muscle occurred in 16% of DTC in this series. Excision of the muscle en bloc with thyroidectomy, particularly in larger tumors, may confer benefit in accurately staging the disease, encompassing occult ETE and achieving clear microscopic margins. |
| Databáze: | OpenAIRE |
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