THE UNEXPECTED THYROID-CANCER - SURGICAL ATTITUDE

A series of 18 patients with unexpected well-differentiated cancers of the thyroid is presented. This proved to be a high percentage of all patients operated for ''benign'' thyroid disease (6,5%), and a substan tial percentage of all patients operated for thyroid cancer (44%). Pre operative investigations consisting mainly of thyroid function tests, ultrasound, scintigraphy, and fine needle aspiration biopsy, were not contributive for cancer. Intraoperative suspicion of malignancy induce d extended surgery in one patient and frozen section biopsies in anoth er 5 patients, with 3 positive answers resulting in immediate more rad ical operations. In 12 patients unsuspected cancer was diagnosed at pa raffin section. This resulted in reoperation in 8 patients. Considerin g a number of arguments, we advocate a therapeutical guideline which m akes a distinction between tumours which should be reoperated and tumo urs which are adequately treated by the initial resection.