Follicular adenoma of the thyroid - Forum

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Re: Follicular adenoma of the thyroid - Ärzteforum

Post#11 »

Well put, this is exactly the policy we follow, after much disccussions with with our eminent endocrine proffessors.

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Re: Follicular adenoma of the thyroid - Ärzteforum

Post#12 »

Back to the point about the article "demanding" total thyroidectomy for ALL thyroid cancer, in the absence of any valid support--altho there is clearly no absence of rationalizing arguments- Let me just challenge you all with a thought--note how easily surgeons adopt the approach which entails surgery, or more surgery, when the answer is not known, and yet how hard it is to get them to adopt LESS surgery or no surgery all else being equal--and how, inconsistently, they tend to demand all sorts of rigorous scientific trials to prove the non-op or minimal-op approach, while so willing to go the operative route with nowhere near the same level of rigid proof. Total vs subtotal thyroidectomy is a classic case in point--breast conservation vs. mastectomy is another classic example--it is clearly documented in the U.S. (refs on demand) that most surgeons STILL do not "believe" that breast conservation is equally safe and efficacious, and still routinely do mastectomy on women who are eligible for BCT--despite this being the most clearly proven point in the history of medicine, with more prospective randomized trials proving it over 20 years than any other issue in medicine. Many such examples abound in trauma, which I don't need to detail here... What does this say about us, our integrity, our willingness to do some homework for the sake of our patients' best interests, and about our true priorities?? Food for thought.....This may provoke anger in some, but those who take this as a personal affront miss my point.


Re: Follicular adenoma of the thyroid - Ärzteforum

Post#13 »

The question isn't whether follicular adenomas progress to follicular carcinomas. Rather it is whether or not you can be sure that the pathology was indeed benign. Roughly 30% of fine needle biopsies which are read as follicular neoplasms prove to be carcinomas when removed. For this reason most people recommend lobectomy for follicular neoplasms. I am not familiar with any data about progression of benign adenomas to cancer. Actually, a substantial number of carcinomas found in this situation prove to be follicular variants of papillary ca, rather than follicular ca. Our results with regard to this will be published next month in Am J Surg.

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