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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Related Experiment Video

Updated: Jul 18, 2025

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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INCIDENTAL THYROID CANCER IN THE PYRAMIDAL LOBE & IMPLICATIONS FOR THYROIDECTOMY.

Diluka Pinto1, Gayana Mahendra1, Ranil Fernando1

  • 1University of Kelaniya, Sri Lanka.

The Ceylon Medical Journal
|August 23, 2023
PubMed
Summary

Complete thyroid removal requires eliminating embryological remnants (ERs). Failing to remove these remnants can lead to disease recurrence and complex reoperations, highlighting the importance of their intraoperative removal.

Keywords:
Pyramidal lobeincidental thyroid carcinomathyroid carcinoma

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Pathology

Background:

  • Embryological remnants (ERs) are potential sites for thyroid pathology recurrence after thyroidectomy.
  • Incomplete removal of ERs can complicate reoperations and management.
  • The incidence of overt malignancy within ERs is low, but their role in disease recurrence is significant.

Purpose of the Study:

  • To emphasize the necessity of complete ER removal during total thyroidectomy.
  • To report the rare occurrence of incidental papillary microcarcinoma within ERs.
  • To advocate for the routine removal of ERs as a standard surgical practice.

Main Methods:

  • Review of literature on ERs and thyroidectomy outcomes.
  • Case report of two patients with incidental papillary microcarcinoma in the pyramidal lobe (an ER).
  • Analysis of the implications of residual ERs on patient management and surgical outcomes.

Main Results:

  • Incidental papillary microcarcinoma in ERs, specifically the pyramidal lobe, has not been previously reported.
  • Two cases of incidental papillary microcarcinoma within the pyramidal lobe were identified.
  • Residual ERs can harbor malignancy and contribute to disease recurrence, necessitating careful intraoperative assessment.

Conclusions:

  • Complete removal of ERs during total thyroidectomy is crucial for preventing disease recurrence.
  • The presence of incidental papillary microcarcinoma in ERs underscores the importance of their thorough removal.
  • Routine removal of ERs should be considered the standard of care in total thyroidectomy procedures.