[Approach to cytologically-benign recurrent thyroid cysts].
BACKGROUND
The aim of this study was to determine the incidence of carcinoma in cytologically-benign recurrent thyroid cysts and to evaluate the surgical indications in these patients.


METHODS
We reviewed all patients undergoing thyroid surgery between January 1992 and December 2002 for cytologically-benign solitary or dominant cystic nodules in multinodular goiter that recurred after aspiration. Mixed nodules were excluded.


RESULTS
Thirty-four patients (29 women and five men) with a mean age of 43 years (18-76) underwent surgery. Seventy-five percent were solitary nodules and 25% were dominant nodules within a multinodular goiter. The mean number of fine needle aspirations with complete drainage was 2.3 (2-3) per patient with hemorrhagic aspirate in 35%. Total thyroidectomy was performed in multinodular goiters and lobectomy with isthmectomy in solitary nodules. Intraoperative biopsy revealed benign lesions in 91% and was inconclusive in the remainder; no cases of carcinoma were identified. Definitive pathologic findings revealed the nodule to be a papillary carcinoma in 3 patients (8.8%) and occult papillary carcinoma separate from the cyst in 4 patients (11.8%). In all these patients intraoperative biopsy showed benign disease. The risk of malignancy was higher in cysts larger than 3 cm (23% vs 0%; p<0.05).


CONCLUSIONS
Given the incidence of carcinoma, surgical resection should be considered in recurrent cystic thyroid nodules, especially in those larger than 3 cm, regardless cytological study.
Pla-Martí
Vicente
V
Servicio de Cirugía General y del Aparato Digestivo, Hospital de Sagunto, Sagunto, Spain. vplamarti@yahoo.es
Fernández-Martínez
Cristina
C
Pallas-Regueira
Antonio
A
Rodríguez-Carrillo
Rodolfo
R
Ibáñez-Arias
Alberto
A
Flors-Alandí
Carlos
C
Roig-Vila
José Vicente
JV
D000293:Adolescent; D000328:Adult; D000368:Aged; D003560:Cysts / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013959:Thyroid Diseases / Q000150:complications* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery