title: The utility of frozen section examination for determining the extent of thyroidectomy in patients with a thyroid nodule and "atypia/follicular lesion of undetermined significance".
abstract: BACKGROUND
  The purpose of this study was to evaluate the role of frozen section examination (FSE) for determining the extent of thyroidectomy in patients with nodular thyroid disease and fine-needle aspiration categorized as atypia/follicular lesion of undetermined significance (AFLUS).
  
  
  METHODS
  A retrospective review of all patients operated on for a thyroid nodule and AFLUS was completed to determine the role of clinical examination and FSE in intraoperative decision making.
  
  
  RESULTS
  One hundred twenty patients with AFLUS underwent thyroidectomy; 18 (15%) had carcinoma. FSE altered management in 36 (62%) of the 58 patients-32 with benign disease and 4 with cancer who underwent lobectomy and total thyroidectomy, respectively. Total thyroidectomy without FSE was performed in 61 (51%) patients with sonographically confirmed bilateral disease. FSE had a 36.4% sensitivity, 100% specificity, 100% positive predictive value, 87% negative predictive value, and 88% accuracy.
  
  
  CONCLUSIONS
  Ultrasound in combination with FSE is of value for determining the extent of thyroidectomy in patients with AFLUS.
authors.affiliation: Department of Surgery, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44109, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Posillico
authors.affiliation: Department of Surgery, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44109, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wilhelm
authors.affiliation: Department of Surgery, MetroHealth Medical Center, H-918, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. Electronic address: cmchenry@metrohealth.org.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McHenry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections / Q000706:statistics & numerical data*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult
keywords: Atypia/follicular lesion of undetermined significance; Frozen section examination; Intraoperative management; Thyroid nodule