THE VALUE OF FROZEN-SECTION EXAMINATION IN PLANNING SURGERY FOR FOLLICULAR THYROID NEOPLASMS

Frozen section examination of follicular neoplasms of the thyroid has been claimed to be of little value in planning the extent of surgery. Clinical factors such as age, sex and tumour size are said to be more accurate predictors of malignancy. The aim of this study was to examin e the respective value of clinical factors and frozen section in the s urgical management of follicular thyroid neoplasms. A retrospective st udy of 735 patients with follicular neoplasms treated at Royal North S hore Hospital was undertaken. Factors assessed included clinical featu res, such as age and sex of the patients and tumour size, as well as f indings at frozen section examination. No significant difference in se x distribution was demonstrated when comparing follicular adenoma with follicular carcinoma. There was a significant difference with respect to patient age between the two groups, but the large overlap in the d istribution made this difference of no clinical value. In addition, th ere was no significant difference in tumour size when comparing follic ular adenoma with carcinoma. On the other hand, review of frozen secti on results showed that 40% of patients with follicular carcinoma were positively identified by frozen section examination at initial surgery , with a false positive rate of less than 0.2%. It appears that clinic al factors, such as age, sex and tumour size, are of little assistance in differentiating benign from malignant follicular neoplasms. Frozen section examination remains the most definitive tool in planning intr a-operatively the extent of surgery for follicular neoplasms of the th yroid.