[Diagnosis and surgical management of Hashimoto's disease coexistent with thyroid carcinoma].
OBJECTIVE
To study clinical assessment and management of the Hashimoto's disease coexistent with thyroid carcinoma.


METHODS
A retrospective analysis in 182 cases of Hashimoto's disease treated from 1982 to 1998 were undertaken. The preoperation assessment, surgical management and the complication after operation had been studied.


RESULTS
Eighteen cases of thyroid carcinoma were found in total of 182 patients. The coexistent rate of the Hashimoto's disease with thyroid carcinoma was 9.9% (18/182). Preoperative diagnostic accuracy was only 33.3% (6/18). The 5-year and 10-year survival rates were 88.9% (16/18) and 81.3% (13/16), respectively. Seven received second operation, 2 of them found cancer in the specimens . The 5 years survival rates of the differentiated thyroid cancer (88.2%) was higher than the undifferentiated thyroid cancer (0), but there were no statistical difference due to the small cases (P = 0.167). Two patients had local recurrence and 3 had metastases. They had salvage surgery, which was curative. Three patients with undifferentiated thyroid cancer died of remote metastases. Six patients suffered hypothyroidism.


CONCLUSIONS
The preoperation diagnosis accuracy of Hashimoto's disease coexistent with thyroid carcinoma was low. A detail case history,computed tomography (CT), fine needle aspiration (FNA) can help the disease to be diagnosed. The surgical treatment is effective on patients with Hashimoto's disease coexistent with thyroid carcinoma.
Ge
Jun-heng
JH
Department of Head and Neck Surgery, Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China. gejunheng1965@yahoo.com.cn
Yao
Yuan
Y
Zhao
Rui-li
RL
Hu
Jun-lan
JL
D000328:Adult; D005260:Female; D050031:Hashimoto Disease / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*