Abstract:Objective:To investigate the diagnosis and treatment of bilateral thyroid carcinoma.
Methods:The clinical records of 72 cases of bilateral thyroid carcinoma from 2000 to 2008 were retrospectively analyzed.
Results:All cases were confirmed as bilateral thyroid carcinoma by paraffin section post-operatively. They included 17 cases of bilateral micro-carcinoma, 41 cases of one lateral micro-carcinoma and other lateral non-microcarcinoma, and 14 cases of non- microcarcinoma. Pathological type was divided into 4 types: papillary carcinoma (67 cases,93.1%), follicular carcinoma(2 cases,2.8%), medullary carcinoma(2 cases,2.8%),poorly differentiated carcinoma(1 case,1.4%).Among them, 62 cases were treated with total thyroidectomy, 2 cases with near total thyroidectomy, and 8 cases with a lobectomy and a sub-total thyroidectomy. Central region lymph nodes were resected in all cases, and additional unilateral functional lymph nodes resection was performed in 19 cases. Central region lymph nodes metastasis rate was 33.33%(24/72),and for bilateral micro-carcinoma of thyroid it was 17.65%(3/17). There was some relationship between central region lymph nodes metastasis rate and cancer diameter, but no significant difference was shown(P>0.05). Seventy patients were followed up from 3 months to 8 years post-operatively, with tumor-free survival in 67 cases, and cervical lymph nodes metastasis in 3 cases. No permanent hypo-parathyroidism or paralysis of recurrent laryngeal nerves occurred.
Conclusions:Total thyroidectomy is advised for bilateral thyroid carcinoma. It is necessary to emphasize the importance of resection of the central region lymph nodes.