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An Emerging Entity That Warrants Aggressive Treatment

Richard F. Grossman, MD; Shih-Hsin Tu, MD; Quan-Yang Duh, MD; Allan E. Siperstein, MD; Faina Novosolov; Orlo H. Clark, MD

Arch Surg. 1995;130(8):892-899.

Abstract
Objective
To determine whether familial nonmedullary thyroid carcinoma behaves like sporadic carcinoma of follicular cell origin.

Design
Retrospective review.

Setting
University medical center.

Patients
Fourteen patients were treated for familial nonmedullary thyroid carcinoma between 1980 and 1994. Thirteen families were identified, with 30 affected individuals.

Interventions
Patients were treated with total or completion total thyroidectomy. Thirteen additional operations were performed to control recurrent disease.

Main Outcome Measures
Stage, recurrence, and survival. Patients were followed up for a mean of 6.5 years.

Results
In our 14 patients, 13 tumors were multifocal, and six of these were bilateral. The incidences of lymph node metastasis and local invasion were both 57% (n=8). Seven patients (50%) had recurrences during follow-up.

Conclusions
Familial nonmedullary thyroid carcinoma has a high incidence of multifocality and invasion and a high rate of local recurrence. Aggressive initial treatment and careful follow-up seem to be indicated.

(Arch Surg. 1995;130:892-899)

Author Affiliations
From the Department of Surgery, Mount Zion Medical Center of the University of California at San Francisco (Drs Grossman, Duh, Siperstein, and Clark and Ms Novosolov), and Department of Surgery, Cathay General Hospital, Taipei, Taiwan, Republic of China (Dr Tu).

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