甲状腺癌的误诊和二次手术的探讨

目的探讨分化型甲状腺癌误诊误治的原因及再手术的方法.方法对近5年收治的因误诊误治后给予再手术的48例分化型甲状腺癌资料进行回顾性分析.结果误诊原因有:首次在外院按甲状腺瘤作肿瘤摘除或腺叶部分切除手术44例,在我院术后冷冻切片证实误诊4例.再手术病理有残癌占46.3%,有颈淋巴细胞转移占22.6%.结论对甲状腺单发结节应通过各种检查排除恶性的可能.首次手术误诊后应尽早选择合理的手术方式进行第二次手术治疗.

Misdiagnosis and reoperation in differentiated thyroid carcinoma

Objective To investigate the causes of misdiagnosis and the indication of differentiated thyroid carcinoma(DTC) and its reoperation.Methods A retrospective analysis was performed 48 cases of misdiagnosed and reoperated DTC treated in our hospital in recent 5 years.Results Causes of misdiagnosis consisted of 44 cases of tumour enucleation or partial lobectomy carried out in other hospitals as for simple adenoma and 4 cases of inadequate operation because of wrong pathological diagnosis of intraoperative biopsy in our hospital.Conclusion In thyroid solitary nodular lesions,every effort should be made to exclude the malignary.Once it is proved to be misdiagnosed,reoperation with edequate technique should be performed as soon as possible.