Defining the role of fine-needle aspiration of thyroid nodules in male patients: Is it necessary? the

Division of Endocrine Surgery, Department of Surgery, St. John Hospital and Medical Center, 22151 Moross Rd., PB1 Suite 332, Detroit, MI 48236, USA.
American journal of surgery (Impact Factor: 2.29). 04/2008; 195(3):396-8; discussion 398-400. DOI: 10.1016/j.amjsurg.2007.12.007
Source: PubMed


The purpose of this investigation was to show that fine-needle aspiration (FNA) of thyroid nodules in male patients may not be necessary in diagnosing thyroid cancer.
We performed a retrospective review of 130 adult male patients who underwent total thyroidectomy from January 2000 to January 2006 at a single institution. The preoperative FNA data for these subjects were reviewed and compared with the surgical pathology reports.
During the study period, 70 of 130 (54%) had FNA, whereas 60 of 130 (46%) did not have FNA. Among all patients, 66 of 130 (51%) had a final pathology diagnosis of thyroid cancer and FNA was performed in 41 of 66 (62%) of these patients. The FNA pathology then was compared with the final pathology.
In our study there was a high false-negative rate for FNA biopsy in the detection of thyroid malignancy in males. An alternative to FNA biopsy in male patients with thyroid nodules may be to go directly to surgery.

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    ABSTRACT: It has recently been suggested that the use of fine-needle aspiration (FNA) biopsy of thyroid nodules in male patients is associated with an unacceptably high false-negative rate in the detection of thyroid malignancy. We hypothesize that FNA biopsy is an accurate preoperative tool for detecting thyroid cancer in men, and that false negative rates are significantly lower than recently reported. A retrospective database analysis was performed on all male patients who underwent thyroid surgery from May 1994 through January 2007 at a single institution. The results of preoperative FNA biopsies were compared with final surgical pathologic results. FNA biopsy results were reported as benign, malignant, inconclusive (i.e., follicular neoplasm), or nondiagnostic; final surgical pathology was reported as benign or malignant. Of 1205 patients who underwent thyroidectomy, 273 (23%) were male. Preoperative FNA biopsy results were obtained in 60% of these male patients and were read as benign in 45/165 (27%) patients, malignant in 47/165 (28%) patients, inconclusive in 66/165 (40%) patients, and nondiagnostic in 7/165 (4%) patients. In male patients with cytology reported as benign, 3/45 (6.7%) FNAs were determined to be malignant on final pathology. Our study determined that FNA biopsy of thyroid nodules in male patients has an acceptably low false-negative rate of 6.7% and is, therefore, an accurate and useful diagnostic tool. We recommend preoperative FNA biopsy for all male patients presenting with thyroid nodules as a standard of practice.
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    ABSTRACT: We report a 60 year-old non smoker female with laryngeal squamous cell carcinoma for which total laryngectomy and right conservative neck dissection was decided. Right hemithyroidectomy is usually a part of this procedure but in this case because of inadvertent ligation of the left inferior thyroid artery, total thyroidectomy was undertaken. A small nodule 0.5 cm of papillary microcarcinoma in the left lobe that was not diagnosed preoperatively was discovered in the final pathological examination. So ultrasound evaluation of the thyroid gland should be added to the work-up of all cases undergoing total laryngectomy and there is a need for new guidelines to treat incidental thyroid lesions in the context of laryngeal cancer.
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