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Pregnancy as a predisposing factor in thyroid neoplasia
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1986
Summary
Thyroid neoplasia during pregnancy often presents as a solitary nodule, with some cases worsening despite treatment. Surgery is safe during pregnancy or postpartum, with a high rate of benign and malignant tumors.
Area of Science:
- Endocrinology
- Obstetrics and Gynecology
- Surgical Oncology
Background:
- Thyroid neoplasia during pregnancy is uncommon but requires careful management.
- Pregnancy can influence the behavior of thyroid nodules, potentially leading to increased growth.
Purpose of the Study:
- To evaluate the incidence, clinical presentation, and management of thyroid neoplasia in pregnant patients.
- To assess the safety and outcomes of surgical intervention for thyroid neoplasia during or after pregnancy.
Main Methods:
- Retrospective analysis of 30 pregnant patients with thyroid neoplasia.
- Review of clinical data, ultrasound findings, needle aspiration biopsy results, and surgical outcomes.
- Correlation of pregnancy stage with nodule behavior and diagnostic accuracy.
Main Results:
- Thyroid neoplasia occurred in 80% of patients, with a 43% cancer incidence and 37% adenoma incidence.
- 20% of patients experienced significant nodular growth during pregnancy despite treatment.
- Fine-needle aspiration biopsy (FNAB) had a 50% cancer detection rate; surgery confirmed malignancy in 43% of cases.
- Surgical outcomes were favorable, with no major morbidity; 26 operations were performed (2 during pregnancy, 24 postpartum).
Conclusions:
- Thyroid neoplasia during pregnancy may have an increased cancer incidence and potentially aggressive behavior.
- Pregnancy can aggravate the course of thyroid neoplasia.
- Timely diagnosis via FNAB and clinical assessment allows for appropriate surgical selection, with procedures safely performed in the second trimester or postpartum.