Surgical approach to encapsulated follicular variant of papillary thyroid carcinoma: a report of three cases

Year 2008, Volume: 18 Issue: 6, 384 - 388, 20.12.2008

Ahmet Eyibilen İbrahim Aladağ Mehmet Güven Reşit Doğan Köseoğlu

Abstract

The diagnosis of follicular variant of thyroid papillary carcinoma is often difficult with fine-needle aspiration biopsy since this variant contains both benign and malignant follicular structures. The encapsulated follicular variant poses even more difficulty for diagnosis. It is usually agreed that this variant has similar clinical behavior to that of classic thyroid papillary carcinoma. However, some recent cases have been shown to have an aggressive course, leading to controversy as to the type of surgery. We presented three female patients whose results of fine-needle aspiration biopsy were not malignant, but postoperative histopathologic diagnosis was made as encapsulated follicular variant. One patient underwent thyroid lobectomy for a single thyroid nodule, and two patients underwent subtotal thyroidectomy. Upon histologic diagnosis of encapsulated follicular variant, total thyroidectomy was performed in two patients. Encapsulated follicular variant should be borne in mind in patients with a benign fineneedle aspiration biopsy result.

Keywords

Biopsy, fine-needle, carcinoma, papillary, follicular, thyroid neoplasms, thyroidectomy/methods

Tiroid papiller karsinomunun kapsüllü folliküler varyantında cerrahi yaklaşım: Üç olgu sunumu

Abstract

Tiroid bezi papiller karsinomlarının folliküler varyan- tında benign ve malign özellikleri taşıyan folliküllerin bir arada bulunması nedeniyle, ince iğne aspirasyon biyopsisinde yanlış tanı sıktır. Tiroid bezi papiller kar- sinomunun folliküler varyantının kapsüllü formunda ise tanısal zorluk daha çoktur. Bu lezyonların klinik seyrinin klasik varyant gibi yavaş ilerlediği, hatta daha ılımlı olduğu söylenmektedir. Ancak, son yıllar- da agresif seyirli olgular da bildirilmiştir. Bu nedenle, cerrahi tedavinin şekli de tartışılmaktadır. Bu yazı- da, ince iğne aspirasyon biyopsi sonuçları malign olmayan ve ameliyat sonrası histolojik incelemede kapsüllü folliküler varyant tanısı konan üç kadın hasta sunuldu. Bir hastaya tek nodül olduğu için tiroid lobek- tomi, ikisine de subtotal tiroidektomi yapıldı. Ameliyat sonrasında histolojik inceleme sonucunda kapsüllü folliküler varyant tanısı konması üzerine, iki hastaya total tiroidektomi yapıldı. Tiroid ince iğne aspirasyon biyopsisi sonucu malign olan olgularda bu varyanta dikkat çekmek amaçlandı

Keywords

Biyopsi, ince iğne, karsinom, papiller, folliküler, tiroid neoplazileri, tiroidektomi/yöntem

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