, Ritter, Amit1,2
; Bachar, Gideon1,2
; Hirsch, Dania2,3
; Benbassat, Carlos2,4
; Katz, Orna1,2
; Kochen, Nadav1,2
1 Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Israel
2 Sackler School of Medicine, Tel-Aviv University, Israel
3 Endocrine Institute, Rabin Medical Center, Israel
4 Endocrine Unit, Assaf Harofeh Medical Center, Israel
Bilateral thyroid nodularity is considered an indication for total thyroidectomy in PTC patients. However, the natural history and outcome of contralateral nodules has never been studied.
To investigate the natural history of non-suspicious contralateral nodules after lobectomy for PTC.
We included patients who had ?1 nodules (?3mm) in the contralateral lobe prior to surgery that was benign on cytology, or small and not suspicious per ultrasound.
One hundred and eighteen patients were included in the study, operated between 1/2002-12/2013. Median age was 57 years, and median size of PTC (lobectomy specimen) was 8mm (range 0.5-40). Median size of contralateral nodules was 7mm (range 3-30). Thirty-four nodules (29%) had FNA before surgery, and none was suspicious. After median follow-up of 6 years, 29 nodules (25%) increased in size ?3mm, with median growth of 6mm (range 4-19). Twenty-two patients (19%) developed new nodules. Fifteen patients (13%) underwent completion thyroidectomy for growth (3), suspected malignancy on FNA (9 with Bethesda III-V), or malignancy (3). Overall, based on the completion thyroidectomy specimen, 8 patients (7%) were diagnosed with contralateral PTC (5 microPTC, one 20mm), and are all without evidence of disease at the end of follow-up. There were no surgical difficulties or local complications during completion surgery.
Lobectomy in patients with PTC and contralateral non-suspicious thyroid nodule/s is safe, but requires regular ultrasound follow-up as growth is seen in 25% of patients. In the few patients who required completion thyroidectomy, treatment with surgery and radioiodine was effective.