Tumores malignos da tireóide: clínica e epidemiologia

Abstract

In the period from April 1973 to July 1999, 116 patients with malignant thyroid tumors were operated on or followed up at the Hospital de Clínicas, Universidade Federal de Uberlândia. This study consisted of collecting data from the medical records of these patients to assess the clinical and epidemiological characteristics of malignant thyroid tumors. Until July 1998 this study was done retrospectively, and from then on the data were collected prospectively. Papillary carcinoma was the most frequent of all malignant thyroid tumors and the proportion between papillary and foramicular carcinomas was compatible with a region of moderate iodine intake. The female sex was the most affected in all tumor forms except metastatic. The age of our patients at the time of diagnosis of papillary, medullary and undifferentiated tumors was found to be close to that described by other authors. On the other hand, in cases of fistular carcinoma, the age at diagnosis was lower than that found in the literature. Most patients with differentiated and spinal carcinomas had an asymptomatic nodule at the time of diagnosis and belonged to the groups at low risk of recurrence and lethality. The association of thyroid carcinoma and hyperthyroidism was relatively high in our country. On the other hand, colloid goiter and chronic thyroiditis were the most frequent associated diseases. Fine needle aspiration was shown to be sensitive and was decisive in indicating surgical treatment in most cases. The most frequently performed surgical procedure was total or almost total thyroidectomy, and surgical complications such as hypoparathyroidism and lower laryngeal nerve injury occurred at a frequency similar to that described in the literature.