Surgical treatment of postoperative, incidentally diagnosed small sporadic C-cell carcinomas of the thyroid.
OBJECTIVE
The surgical strategy in small sporadic C-cell carcinomas of the thyroid that are incidentally diagnosed after goiter resection for benign disease is controversial. It remains unclear whether a completion thyroidectomy should be performed in every case.


METHODS
We present nine patients who were operated on between October 1992 and October 1997 in whom an unexpected, small sporadic C-cell carcinoma (seven with pT1, two with pT2) was found in the postoperative histology.


RESULTS
All patients were calcitonin negative and there were no signs of the disease being inherited (no familial history, negative RET proto-oncogene). No patient underwent a completion thyroidectomy. All patients had a follow-up with pentagastrin-stimulated calcitonin and carcinoembryonic antigen (CEA) 3 months, 6 months and annually after the operation. No patient became calcitonin positive or showed any other signs of tumor recurrence after a follow-up period of 2-7 years.


CONCLUSIONS
A completion thyroidectomy is not necessary in small sporadic C-cell carcinoma that is incidentally diagnosed after resection for benign disease if there is no sign of familial cancer and if calcitonin is negative. A close follow-up is necessary.
Cupisti
K
K
Klinik für Allgemein und Unfallchirurgie, Heinrich-Heine-Universität Düsseldorf, Germany.
Simon
D
D
Wolf
A
A
Gerharz
C D
CD
Goretzki
P E
PE
Dotzenrath
C
C
Witte
J
J
Röher
H D
HD
D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood / Q000187:drug effects*; D002272:Carcinoembryonic Antigen / Q000097:blood; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010418:Pentagastrin / Q000494:pharmacology; D011379:Prognosis; D000090063:Proto-Oncogene Mas; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen; C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas; D002116:Calcitonin; D010418:Pentagastrin