Table 3. Summary of the literature on thyroid cancers that were discovered incidentally at thyroidectomy in patients underwent surgery for benign thyroid disease.
| Author (ref) | Years of study | Country | Patients studied | Surgical procedure | Rate of cancer | Comment |
|---|---|---|---|---|---|---|
| Fama’ and cols., this study | One (2014) | France | 207 pts | TT | In 25/207 (12.1%) pts, 37 PTC were detected (31 microPTCs and 6 PTCs) | 10/25 (40.0%) pts had multifocal tumours; all pts underwent surgery for MNG |
| Daumerie and cols., 1998 | 1976 - 1995 | Belgique | 93 pts | TT in 16/47 (34.0%) pts with MNG (group I), PT in 39/46 (84.8%) pts with a solitary hot nodule (group II) | 2/16 (12.5%) pts (group I) and 5/39 (12.8%) pts (group II) had microTC, with a total prevalence of 12.7% | |
| Dănilă and cols., 2008 | 2000 - 2006 | Germany | 92 pts | TT | 2/92 (2.2%) pts had microPTC (tumour size ranged from 3 to 5 mm) | All pts had GD; multifocality and lymph node involvement were not detected |
| Pezzolla and cols., 2014 | Jan 2010 - Jun 2013 | Italy | 256 pts | Surgical procedures in tumours pts 28/256): TT in 27/28, PT in 1/28 PT | In 28/256 (10.9%) pts, 40 TCs were detected (29 FV-PTC, 10 PTC and 1 FTC) | Pts underwent surgery for: 176 pts (MNG), 67 pts (GD), 12 pts (UNG) and 1 pt (PD) |
| Pezzolla and cols., 2010 | n/a | Italy | 165 pts | n/a | 30/165 (18.2%) pts had TC (18 PTC, 6 FTC, 5 FV-PTC and 1 oncocytic carcinoma); 15/30 (50%) were microcarcinomas | Pts underwent surgery for: 132 pts (MNG), 30 pts (UNG), 2 pts (PD) and 1 pt (GD) |
| Costamagna and cols., 2013 | 2001 - 2009 | Italy | 568 pts | TT in 499/568, PT in 69/568 | 53/568 (9.3%) pts had TC (24 FV-PTC, 20 PTC, 4 FTC, 4 MTC and 1 primitive thyroid paraganglioma); 32/53 (60.4%) had microPTCs | 14/53 (26.4%) pts had multifocal tumours and in 12/53 (22.6%) were bilateral |
| Negro and cols., 2013* | 2000 - 2010 | Italy | 970 pts | TT | 84/ 970 (8.7%) pts had TC | |
| Botrugno and cols., 2011 | 2000 - 2008 | Italy | 462 pts | TT | 41/462 (8.9%) pts had TC; the most common histotype was PTC | |
| Gelmini and cols., 2010 | 10 yrs | Italy | 739 pts | TT in 503/739, PT in 239/739 | 82/739 (11.1%) pts had TC, mainly microPTC | Lymph-node metastases were found in the 3.6% of cases |
| Pisello and cols., 2007 | Jan 2000 - Jan 2006 | Italy | 502 pts | TT in 458/502, PT in 44/502 | 17/502 (3.4%) pts had microPTC | In 34/502 (6.8%) pts, tumours were suspected preoperatively; 2/502 (0.4% had multifocal microPTCs |
| Carlini and cols., 2006* | n/a | Italy | 88 pts | TT | 19/88 (21.6%) pts had TC | |
| Miccoli and cols., 2006 | Feb 2002 - Nov 2003 | Italy | 998 pts | TT in 902/998 pts, PT in 96/998 | 104/998 (10.4%) pts had TC; the most common histotype was PTC (99/104) | Tumours were multifocal in 19.8% of the cases |
| Carlini and cols., 2005* | 1-year | Italy | n/a | n/a | Incidence of microTC was 27.4% | |
| Pingitore and cols., 1993 | 1985 - 1991 | Italy | 2930 pts | n/a | 132/2463 (5.4%) pts had TC | 2463/2930 pts were considered clinically benign and 467/2930 pts malignant, preoperatively |
| Pascual Corrales and cols., 2012 | n/a | Spain | 372 pts | n/a | 58/372 (15.6%) pts had TC | Pts underwent surgery for: 49 pts (EMNG), 8 pts (GD) and 1 pt (HMNG) |
| Slijepcevic and cols 2015 | ., 2008-2013 | Serbia | 2466 pts | TT or PT | 403/2466 (16.3%) pts had microPTC | |
| Zivaljević and cols., 2008 | 2004 | Serbia | 578 pts | n/a | 53/578 (9.2%) pts had microTC | Pts underwent surgery for: 201 pts (MNG), 178 pts (thyroid adenoma), 89 pts (GD), 79 pts (PD) and 31 pt thyroiditis |
| Alecu and cols., 2014 | 2002 - 2012 | Romania | 145 pts | TT in 102/145 pts, PT in 43/145 | 10/145 (6.9%) pts had microPTC | |
| Muntean and cols., 2013 | 2002 - 2011 | Romania | 2168 pts | TT or PT | 187/2168 (8.6%) pts had microPTC | In 66/187 (35.3%) pts had multifocal tumours, and in 31/187 (16.6%) were bilateral |
| Lukás and cols., 2010 | 2004 - 2008 | Czech Republic | 400 pts | TT or PT | 34/400 (8.5%) pts had microTC; 32/34 (94.1%) were microPTCs | In 5/34 (14.7%) pts had multifocal tumours and in 4/34 (11.8%) were bilateral |
| Nechaĭ and cols., 2012* | 2008 - 2009 | Ukraine | 608 pts | n/a | 56/608 (9.2%) pts had TC; 43/56 (76.8%) were microPTCs | |
| Barczyński and cols., 2011* | 1999 - 2009 | Poland | 8132 pts | TT in 2918/8132 pts, PT in 5214/8132 | 406/8132 (5.0%) pts had TC | |
| Vasileiadis and cols, 2013 | 2001 - 2009 | Greece | 2236 pts | TT | 268/2236 (12.0%) pts had microPTC. | |
| Siassakos and cols. 2008 | Jan 1997 - Jul 2001 | Greece | 191 pts | TT | 29/191 (15.2%) pts had microTC (18 microFTC, 10 microPTC and 1 microMTC) | In 8/29 (27.6%) pts had multifocal microcarcinomas |
| Sakorafas and cols. 2007 | Feb 1990 - Feb 2002 | Greece | 380 pts | TT in 377/380 pts, PT in 3/380 | 27/380 (7.1%) pts had microPTC | In 11/27 (40.7%) pts had multifocal tumours |
| Yazici and cols., 2015 | 2010-2013 | Turkey | 86 pts | TT or PT | 6/86 (7.0%) pts had TC (4 microPTC and 2 PTC) | |
| Tasova and cols., 2013 | Mar 2007 - May 2011 | Turkey | 443 pts | TT in 401/443, PT in 42/443 | 66/443 (14.9%) pts had TC (56 PTC, 4 FTC and 6 indeterminate lesions) | |
| Karakoyun and cols 2013 | Jan 2010 - Aug 2011 | Turkey | 50 pts | TT | 5/50 (10.0%) pts had microPTC. | |
| Berker and cols., 2011 | Jan 2004 - Jan 2009 | Turkey | 337 pts | TT | 18/337 (5.3%) pts had microTC | Pts underwent surgery for: 278 pts (MNG), 59 pts (GD) |
| Tezelman and cols., 2009 | 1988-2007 | Turkey | 2906 pts | PT in 1695/2906 (group 1), TT in 1211/2906 (group 2) | 210/2906 (7.2%) pts had TC (81 in group 1 and 129 in group 2) | |
| Giles and cols., 2004 | Sep 2001 - Dec 2002 | Turkey | 218 pts | TT in 109/218 (group 1), and PT in 109/218 (group 2) | 18/218 (8.3%) pts had PTC (10 in group 1 and 8 in group 2) | All pts underwent surgery for MNG |
| Fernando and cols., 2009 | 2003 - 2005 | Sri Lanka | 68 pts | TT | 6/68 (8.8%) pts had TC (2 PTC, 2 MTC and 2 FTC) | |
| John and cols., 2014 | Jan 2005 - Jun 2012 | India | 1300 pts | TT or PT | 94/1300 (7.2%) pts had microPTC | |
| Wu and cols., 1993 | 1962 - 1991 | China | 135 pts | n/a | 54/135 (40.0%) pts had TC | |
| Koh and cols., 1992 | n/a | Malaysia | 107 pts | n/a | 8/107 (7.5%) pts had TC, mainly PTC | All pts underwent surgery for MNG |
| Preece and cols., 2014 | Sep 1994 - Aug 2012 | Australia | 1508 pts | TT | 96/1508 (6.4%) pts had TC | Pts underwent surgery for: 963 pts (MNG), 295 pts (TNG), 250 pts (GD) |
| Bron and cols., 2004 | 1998-2002 | Australia | 834 pts | TT | 71/834 (8.5%) pts had TC (33 microPTC, 22 PTC, 11 FTC, 5 other) | 74/834 had previously undergone PT |
| Bhuiyan and cols., 2015 | 2003-2008 | South Africa | 90 pts | TT | 10/90 (11.1%) pts had TC (3 PTC and 7 FTC) | |
| Bombil and cols., 2014 | 2005-2010 | South Africa | 162 pts | TT | 4/162 (2.5%) pts had PTC (3/4 were FV-PTC) | |
| Edino and cols., 2010 | 2000-2006 | Nigeria | 160 pts | n/a | 24/160 (15.0%) pts had TC (13 FTC, 10 PTC, 1 MTC and 1 ATC) | In 6/25 (24.0%) pts tumours were detected preoperatively by FNAC |
| Choong and cols., 2015 | 1990-2014 | USA | 148 pts | TT (120 pts) or PT (28 pts) | 7/148 (4.7%) pts had TC (5 PTC, 1 FTC and 1 MTC) | All pts underwent surgery for TNG |
| Ergin and cols., 2014 | 2005-2013 | USA | 493 pts | TT | 69/248 (28%) pts in EG group and 64/245 (26%) pts in GD group had microPTC | Pts underwent surgery for: 248 pts (EG), 245 pts (GD) |
| Bahl and cols., 2014* | 2003-2012 | USA | 2090 pts | n/a | 680/2090 (33%) pts had TC | |
| Phitayakorn and cols., 2013 | Dec 1985 - Mar 2010 | USA | 300 pts | TT or PT | 31/300 (10.3%) pts had TC (22 microPTC, 8 PTC and 1 FTC) | |
| Phitayakorn and cols., 2008 | 1990-2007 | USA | 506 pts | TT, PT in 10 pts with GD | 11/333 (3.3%) nonTNG pts had PTC, 2/92 (2.2%) GD pts had microPTC, 5/81 (6.2%) TNG pts had TC (3 PTC, 1 FTC and 1 MTC) | Pts underwent surgery for: 333 pts (nonTNG), 92 pts (GD), 81 pts (TNG) |
| Smith and cols., 2013 | 2000-2011 | USA | 1523 pts | n/a | 238/1523 (15.6%) pts had TC (175 PTC, 39 FV-PTC, 11 FTC and 13 other malignancies) | |
| Smith and cols., 2013* | 2002-2011 | USA | 164 pts | n/a | 30/164 (18.3%) pts had TC | All pts underwent surgery for TNG |
| Dunki-Jacobs and cols., 2012 | 2001-2007 | USA | 723 pts | TT or PT | 194/723 (27%) pts had TC (PTC or microPTC) | In 137/194 (70.6%) pts, tumours were suspected preoperatively |
| Bradly and cols., 2009 | Jan 2000 - May 2008 | USA | 678 pts | TT or PT | 81/678 (12%) pts had PTC | |
| Lokey and cols., 2005* | Dec 1998-Dec 2003 | USA | 738 pts | n/a | 28/738 (3.8%) pts had TC (mainly microPTC) |
pts: patients; TT: total thyroidectomy; PT: partial thyroidectomy; TC: thyroid carcinoma; PTC: papillary thyroid carcinoma; FV-PTC: follicular variant of papillary thyroid carcinoma; FTC: follicular thyroid carcinoma; MTC: medullary thyroid carcinoma; ATC: anaplastic thyroid carcinoma; MNG: multinodular goiter; UNG: uninodular goiter; TNG, toxic nodular goiter; GD, Graves’ disease; PD, Plummer's disease; HT, Hashimoto's thyroiditis; EG, euthyroid goiter; EMNG, euthyroid multinodular goiter; HMNG, hyperthyroid multinodular goiter, FNAC: fine-needle aspiration cytology; n/a: not available.
*
Tabulated data taken from the abstracts written in English and/or illustrative material.