Ten days after performing a hemithyroidectomy on a patient with a 1.5 cm thyroid nodule you receive the following anatomopathologic report: "very cellular follicular pattern without capsular invasion and infiltrating adjacent blood vessels and nerves". Point out the correct answer:
I think the correct answer is 3 answers 2,4 and 5 are clearly false. The doubt is between 1 and 2. The statement of 1 is correct in cases of follicular carcinoma without capsular invasion a total thyroidectomy can be performed. But if there are data of poor prognosis and the possibility of metastases - as in this case - it is best to complete the thyroidectomy and perform a radioactive iodine scan to rule out metastases or treat them if they are present.
As there is no capsular invasion, no further surgery is necessary.
Follicular pattern is an indication for prophylactic cervical lymph node emptying.
This is a follicular carcinoma and requires completion of thyroidectomy.
The report allows us to rule out with total certainty a papillary carcinoma in the remaining thyroid.
Measurement of plasma calcitonin will allow us to distinguish between papillary and follicular carcinoma.
The statement of 1 is correct in cases of follicular carcinoma without capsular invasion a total thyroidectomy can be performed. But if there are data of poor prognosis and the possibility of metastases - as in this case - it is best to complete the thyroidectomy and perform a radioactive iodine scan to rule out metastases or treat them if they are present.
if there are data of poor prognosis and the possibility of metastases - as in this case - it is best to complete the thyroidectomy and perform a radioactive iodine scan to rule out metastases or treat them if they are present.