Browsing by Author "Pradeep, I.H.D.S."

Now showing 1 - 3 of 3

Columnar cell variant of papillary thyroid carcinoma - a rare and clinically aggressive variant
(College of Surgeons of Sri Lanka, 2015) Pradeep, I.H.D.S.; Chandrasinghe, P.C.; Kannangara, K.R.; Epitakaduwa, E.K.G.D.C.; Fernando, R.F.
No abstract available
Detection of incidental thyroid carcinoma is significantly higher in goiters with background thyroiditis
(College of Surgeons of Sri Lanka, 2015) Pradeep, I.H.D.S.; Chandrasinghe, P.C.; Wijewardana, B.D.A.N.; Dissanayaka, D.M.C.D.; Fernando, F.R.; Buddika, U.A.; Kannangara., K.R.
INTRODUCTION: Incidence of 'incidental thyroid carcinoma' (ITC) is reported to be 3 % to 16% in operatively treated benign thyroid diseases. This study analyses the results of a single surgeon performing total thyroidectomy for benign diseases and is the continuation of the study preliminary published in 2009. MATERIAL AND METHODS: All patients, who underwent total thyroidectomy for benign diseases at the unit from January 2003 to October 2014 were included. All patients had preoperative ultrasonography and fine needle aspiration cytology (FNAC). Diagnosis of ITC was based on post op histopathological reporting. Test of proportions with a P value of 0.05 was considered significant. RESULTS: Total thyroidectomy specimens of 449 (Median age- 37 years; range: 25 - 65 years, female – 74.07 %) patients were analyzed. ITC was detected in 6.01% (n=27) of patients. Papillary carcinoma was the commonest (62.96%) subtype. There were 8 (29.62%) follicular and 2 (7.4 %) medullary cancers. Males had a significantly higher proportion of ITC (Male: ITC/benign = 15% Vs Female: ITC/ benign = 5%; P= 0.02). Specimens with ITC reported a significantly higher rate of background thyroiditis (ITC = 33% Vs benign = 15 %; P= 0.02). ITC was not significantly associated with a family history (P= 0.7887). Postoperative transient hoarseness was observed in 3.56%and hypocalcaemia in 10.69%. CONCLUSIONS: A significant proportion of 'benign' goiters may harbor ITC, especially with background thyroiditis. With emerging evidence to support total thyroidectomy with low morbidity it may be prudent to offer total thyroidectomy for benign goiters with background thyroiditis.
Incidental thyroid carcinoma in benign thyroid disease: a longitudinal descriptive study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Pinto, M.D.P; Pradeep, I.H.D.S.; Amaraweera, P.C.; Munasinghe, B.N.L.; Kumarasinghe, K.A.P.R.; Dissanayake, D.M.C.D.; Fernando, R.
BACKGROUND: An incidental thyroid carcinoma (ITC) is a thyroid malignancy that is not clinically or cytologically detected preoperatively. The incidence of ITC is between 10% - 20% in the literature. OBJECTIVES: The study was undertaken to assess the incidence of ITC in patients presenting with benign disease of the thyroid to University Surgical Unit, Colombo North Teaching Hospital, Sri Lanka. METHODS: A longitudinal descriptive study was conducted spanning from November, 2002 to October, 2015 on a cohort of all patients who underwent total thyroidectomy with cytologically benign thyroid disease. FNAC was performed on all palpable lesions to detect presence of malignancy. Presence of autoimmune thyroiditis was taken as an exclusion criterion due to its known association with malignancy of the thyroid. Post-thyroidectomy histopathological diagnoses were provided by Department of Pathology, University of Kelaniya, Sri Lanka and were collected prospectively. Statistical analysis was done by Fisher’s exact test using SPSS software, version 20. RESULTS: Hundred and sixty seven patients (n=167) underwent total thyroidectomy (Male – 2, Female – 17, Median age = 40.25 years, Range 28 – 62 years). ITC was found in 11.38% (19/167) with a female preponderance (13/19). A majority (89.4%) were euthyroid. CONCLUSIONS: Incidence of ITC in benign thyroid disease is 11.38% which may have implications for the management in benign thyroid disease.