Clarifying the Role of Fine-Needle Aspiration Cytologic Evaluation and Frozen Section Examination in the Operative Management of Thyroid Cancer

Abstract

• The final histologic diagnoses of 486 patients who underwent thyroidectomy at UCLA Medical Center from March 1975 to August 1988 were reviewed. There were 146 patients with a diagnosis of thyroid malignant neoplasm. All patients who had preoperative fine-needle aspiration cytologic evaluation, intraoperative frozen section analysis, or both were included in the present study. Carcinoma was diagnosed by frozen section in 87 (69%) of 126 cases. Frozen section analysis was incorrect in 39 (31%) of 126 cases. Fine-needle aspiration was performed in 62 patients. A malignant neoplasm was identified by fine-needle aspiration in 44 (71%) of 62 cases. Fifty-six patients had both preoperative fine-needle aspiration and intraoperative frozen section analysis, and carcinoma was detected by both methods in 32 (57%) of 56 cases. Fine-needle aspiration cytologic evaluation is extremely valuable in the diagnosis of thyroid cancer and is at least as accurate as frozen section analysis with less morbidity and expense. When fine-needle aspiration demonstrates malignant neoplasm, thyroid resection may be planned with confidence. (Arch Surg. 1989;124:1201-1205)