| Objective:To discuss the clinical manifestations, diagnosis, surgical treatment and prognosis of thyroid follicular carcinomaMethods:Follicular thyroid carcinoma cases which were treated in our hospital were collected from Jan.1997to Jan.2006, some of them were follow up.Result:There were66cases,14male,42female, the average age of them was46.8(20-76). Ultrasound Was done in almost all patients with one exception, with17((25.8%,17/66)cases of enlarged lymph nodes.Most common operative method was lobectomy plus isthmusectomy plus contralateral near-total thyroidectomy with26cases((39.4%). Lymphadenectomy was done in16(24.2%,16/66) cases, non was proved of metastases to lymph nodes. There were13(19.7%,13/66)frozen sections mismatch postoperative pathologic findings.3(4.5%,3/66)cases could not distinguish benign or malignant by frozen section.37(41.6%,32/77)cases were follow up, The median follow-up time was61months(a maxium of141months),35(7.6%,5/37)cases recurrent,1case recurrent at the remains,1case had lymph nodes metastases,3case had distant metastases.5(7.6%,5/37)cases died during the follow up period.Conclusions:follicular thyroid carcinoma patientents are mainly female, There are still some errors in the diagnosis of frozen section, Which have a huge impact, on the the patient's Surgical approach and prognosis. With low Lymph node metastasis rate, Lymph node micrometastasis can not be ignored. For those lymph node micrometastasis-positive patients, whether Lymphadenectomy is needed worth discussing. In Our opinion,most follicular thyroid carcinoma patients should have lobectomy plus contralateral near-total thyroidectomy,while only some Microinvasion can go on lobectomy plus isthmusectomy. A preventive lymphadenectomy is not recommended to those NO period patients,however,a improved Lymphadenectomy is encouraged to those N1period patients. |
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