Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules.
BACKGROUND
The role of routine frozen section (FS) in the surgical management of thyroid nodules remains uncertain. This study reviewed the role of FS in the presence of an adequate fine-needle aspiration biopsy (FNAB).


METHODS
FNAB and FS were evaluated in 206 patients who had surgery for a thyroid nodule. Cytological specimens were classified as benign, malignant or suspicious. The FS diagnoses were benign, malignant or deferred.


RESULTS
A cytological diagnosis was obtained in 93 nodules; the remaining 113 were classified as suspicious, of which 21 were malignant on definitive examination. The overall accuracy of FNAB was 53 per cent. FS evaluation identified 165 lesions as benign; the diagnosis was deferred until definitive histological evaluation in only eight. The overall accuracy, therefore, was 96 per cent. Routine use of FS was cost-effective; lowering the number of reoperations led to an estimated saving of about 40 per cent.


CONCLUSIONS
These data suggest that FS remains an important tool in the surgical management of thyroid nodules and can reduce the number of patients requiring reoperation.
Caraci
P
P
Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy.
Aversa
S
S
Mussa
A
A
Pancani
G
G
Ondolo
C
C
Conticello
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000191:economics / Q000379:methods* / Q000592:standards; D003365:Costs and Cost Analysis; D005260:Female; D005629:Frozen Sections / Q000191:economics / Q000379:methods / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology*; D016606:Thyroid Nodule / Q000191:economics / Q000473:pathology / Q000601:surgery*