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Frozen section in thyroid surgery
D Giuliani1, P Willemsen, J Verhelst
1Department of General Surgery, Middelheim General Hospital, Antwerp, Belgium. giuldav@hotmail.com
Acta Chirurgica Belgica
|June 10, 2006
Summary
Frozen section in thyroid surgery shows high specificity but low sensitivity for malignancy detection. Extensive tissue sampling is crucial for accurate diagnosis, which frozen section cannot provide.
Area of Science:
- Surgical Pathology
- Oncology
- Endocrine Surgery
Background:
- Frozen section (FS) is a rapid intraoperative diagnostic tool.
- Its utility in thyroid surgery for malignancy detection requires evaluation.
Purpose of the Study:
- To assess the diagnostic accuracy of frozen section in thyroid surgery.
- To determine the effectiveness of FS in identifying malignancy in thyroid nodules.
Main Methods:
- Retrospective review of 417 thyroid surgery cases (1997-2004).
- Analysis of frozen section data for solitary thyroid nodules.
- Calculation of diagnostic metrics: specificity, sensitivity, PPV, NPV.
Main Results:
- Frozen section was performed in 128 operations.
- Specificity for malignancy was high (98.16%).
- Sensitivity was limited (56.25%), with challenges in diagnosing follicular lesions due to invasion criteria.
Conclusions:
- Frozen section has limitations in providing adequate histopathologic diagnosis for thyroid disease.
- Extensive specimen subsampling, essential for accurate diagnosis, is not feasible during intraoperative FS.
- Final diagnosis relies on comprehensive examination of permanent sections.
