Περίληψη:
BACKGROUND: The pyramidal lobe (PL) represents an upward extension of
the thyroid gland with remarkable variability in terms of presence.
location and size. This prospective study analyzes the significance of
the PL.
METHODS: From January 2013 to September 2015, 538 patients were
prospectively enrolled in the study. Descriptive statistics, differences
of patients with and without PL, differences in PL size
(Kruskal-Wallis/ANOVA tests) and correlations of PL size with age, BMI
and thyroid weight were computed. Odds ratios for the probability of
observing PL size above the median value were analyzed using
multivariate analysis.
RESULTS: Out of 538 patients, 272 (50.6%) had pyramidal lobe, average
size 1.82 cm. Statistically significant higher proportion of patients
with PL was observed for patients with Delphian node presence (P=0.017).
PL size was significantly larger for patients with greater thyroid
weight (P=0.014); male gender (P=0.011) and Delphian node presence
(P=0.021). No difference was found regarding age or BMI. Patients with
multifocal papillary thyroid cancer (PTC)>10 mm had smaller PL size than
patients with minimal multifocal PTC (<10 mm). After adjusting for age,
gender, BMI, and thyroid weight, the odds of observing PL size above the
sample median was significantly lower for patients with Multifocal
PTC>10 mm (P=0.023) and for patients with cervical LN malignancy
(P=0.014).
CONCLUSIONS: PL occurs in 50.6% of patients. Larger size correlates
strongly with big thyroids, male gender and Delphian nodes presence.
Thorough anatomic knowledge and meticulous surgical technique are
required for PL excision and a truly “total thyroidectomy.”
Συγγραφείς:
Kiriakopoulos, Andreas
Ntelis, Spyridon
Petralias, Athanassios
and Linos, Dimitrios
