212003 The diagnosis and surgical treatment of hyperthyroidism complicating thyroid carcinoma

/Hu Ruying(胡如英，Dept Gen Surg，lst Affil Hosp Wenzhou Med Col，Wenzhou 325000)…∥Chin J Gen Surg.-2011，26(8).-648～650

ObjectiveTo evaluate the diagnosis and surgical treatment of primary hyperthyroidism with concurrent thyroid carcinoma.MethodsThe clinical data of 43 hyperthyroidism cases complicating thyroid carcinoma，confirmed by pathology at our hospital from January 1999 to September 2010 were retrospectively analyzed.Results

Preoperatively 40 patients were examined by ultrasound，29 cases were diagnosed with carcinoma，the diagnostic accuracy of ultrasound was 72.5%.Thyroidectomy was performed in all the 43 patients，including subtotal thyroidectomy(5 patients)，homolateral total thyroidectomy and contralateral subtotal thyroidectomy with neck dissection(25 patients)，total thyroidectomy with neck dissection or radical neck dissection(11 patients)and lobectomy plus isthmus resection(2 patients).Postoperative pathology identified papillary carcinoma in 38 cases，and follicular carcinoma in 5 cases.Postoperative temporary hypocalcemia developed in 3 cases and one suffered from irritating when drinking.No hoarseness or blooding.39 patients were followed-up from 2 to 110 months averaging 45 months，there was no tumor recurrence.ConclusionPreoperative routine ultrasonography helps to identify thyroid carcinoma that coexists with primary hyperthyroidism.The postoperative prognosis of thyroid papillary carcinoma concurrent with hyperthyroidism is satisfactory.7 refs，14 figs.