Advantages of ultrasound examination in revealing and follow up of thyroid carcinomas

To show the value of ultrasound examination (UE) in early detection of thyroid cancer (TC) and the impact it has upon the outcome. 500 patients (pts) with TC (395 papillary, 62 follicular, 12 Hurthle cell, 31 medullary) were followed-up in the period from 0, 5 to 35 years (mean 6, 3). They were divided into two groups: A:pts who were submited to UE of the thyroid and neck and in whom tumor and possible lymph node metastases (LNM) were cinfirmed by ultrasonically guided fine needle biopsy (UGFNB) (N=323) ; B:pts who had not been examined by ultrasound before surgery (N=177). Results: In 53% of analyzed pts, TC was recognized by UE due to its typical presentation (hypoechogenous of irregular margins or with tiny calcifications). The pts with LNM had larger TC than those without LNM (p<0, 001) as well as pts with distant metastases (DM). TC<1 cm were found in 134 pts (41, 4%) ftom group A an in 18 (10%) from group B. Total thyroidectomy (TT) was performed in 483 pts. 11% of the pts from group A and 36% from group B underwent partial thyroid resection and subseqently TT. Functional or radical neck dissection with simultaneous TT was done in 12% of the pts from group A and 9, 6% of the pts from the group B. The rates of additional operations performed for metastases revealed later, measured 2, 4 % and 13%, respectively. DM were found in 30 pts (6%) an 11 pts died. UE and UGFNB make it possible to reveal amall TC, also alow detection of possible LNM, wich contributes to compete healing and makes further treatment much easier and less expensive.