Completion Thyroidectomy for Initially Misdiagnosed Differentiated Thyroid Carcinoma-Study of 51 cases

Abstract

Introduction: Completion thyroidectomy is the removal of any residual thyroid tissue that remains after a less than total thyroidectomy. This procedure is usually done when the final histopathlogy of the excised ipsilateral thyroid lobe reveals papillary or follicular carcinoma.

Objective: A retrospective analysis was done of patients undergoing completion thyroidectomy for thyroid malignancy who had undergone surgery elsewhere for solitary thyroid nodule. The incidence of complications in these patients after re-operation was investigated in this study.

Material and Method: Our study included a total 51 patients who had undergone thyroid lobectomy for a solitary nodule as initial surgery in our hospital & elsewhere and were admitted in our hospital for completion thyroidectomy when histopathology revealed malignancy in last 5 years (2014-2018).

Result: In this study-51 patients were enrolled; among them 42 were female and 9 male. Their mean age was 33.6 years (range-17-59 years). After initial surgery, the histopathology revealed papillary carcinoma in 45 patients (88.24%), follicular carcinoma in 6 patients (11.76%). Four out of 51 patients had recurrent laryngeal nerve palsy after initial surgery (7.8%). None of the patients had clinical hypocalcaemia after 1^st surgery. Parathyroid glands are identified and preserved in all patients during completion thyroidectomy. No patient had additional recurrent laryngeal nerve injury in 2^nd surgery. Mean follow-up was one year. Transient hypoparathyroidism occurred in 9.8% patients, but no permanent hypoparathyroidism. Seven patients were lost to follow-up.

Conclusion: Completion thyroidectomy is a safe and appropriate procedure for the management of initially misdiagnosed differentiated thyroid carcinoma.

TAJ 2019; 32(2): 22-26