Limitations of preoperative cytology for medullary thyroid cancer: Proposal for improved preoperative diagnosis for optimal initial medullary thyroid carcinoma specific surgery
| Autor: | Nikolaos Stathatos, Zaid Al-Qurayshi, Lori J. Wirth, Natalia Kyriazidis, Dipti Kamani, Leslie S. Eldeiry, Yin Ren, Richard T. Kloos, Gregory W. Randolph, Anahita Nourmahnad, Emad Kandil, Ryan Saade, Ayse M. Onenerk, Carrie C. Lubitz, Yuri E. Nikiforov, Alan D. Workman, Selen Soylu, William C. Faquin |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
endocrine system diseases Medullary cavity Cytodiagnosis Biopsy Fine-Needle 030209 endocrinology & metabolism Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Cytology medicine Humans Thyroid Neoplasms Thyroid Nodule business.industry Surgical care Medullary thyroid cancer respiratory system medicine.disease digestive system diseases Carcinoma Neuroendocrine Surgery Otorhinolaryngology 030220 oncology & carcinogenesis business circulatory and respiratory physiology |
| Zdroj: | Head & Neck. 43:920-927 |
| ISSN: | 1097-0347 1043-3074 |
| DOI: | 10.1002/hed.26550 |
| Popis: | Background Preoperative diagnosis of medullary thyroid carcinoma (MTC) is often difficult, given the poor sensitivity of fine-needle aspiration (FNA) cytology for MTC. This study investigates this issue and presents recommendations for improving preoperative diagnostic paradigms in MTC cases. Design/method Histopathologically confirmed MTC patients with preoperative cytologic assessment of index nodules were enrolled. FNA diagnosis, final pathology, and surgery details were collected. Results Out of 71 patients, 49 (69%) were diagnosed by FNA as either definitive MTC (35, 49%) or suspected MTC (14, 20%) and 22 (31%) patients had no indication of MTC on FNA. Conclusion In a tertiary-care setting, one-third of subjects had an FNA interpretation that did not suggest the possibility of MTC. The limitations of preoperative diagnosis are especially problematic for MTC as they can cause delayed or incomplete treatment. Additional testing is proposed to improve preoperative diagnosis and surgical care of MTC patients. |
| Databáze: | OpenAIRE |
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