The utility of frozen section evaluation for follicular thyroid lesions

Rachael A. Callcut, Suzanne M. Selvaggi, Eberhard MacK, Omer Ozgul, Thomas Warner, Herbert Chen

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Background: Because fine-needle aspiration cannot reliably discriminate between benign and malignant follicular thyroid lesions, some surgeons use intraoperative frozen section (FS) to guide operative management. To determine the utility of FS for these lesions, we reviewed our institutional experience. Methods: Between 1994 and 2001, 152 patients underwent surgical resection for follicular neoplasms. Results: The mean age of the patients was 47 years, and 76% were female. Forty-one (32%) FSs were reported as benign, 5 (4%) as malignant, and 3 (2%) as indeterminate, and in 80 (62%), the diagnosis was "follicular lesion, deferred to permanent histology." On paraffin section, all patients with malignant FSs had thyroid cancer, and all 41 patients with benign FSs had benign lesions. Thus, FS for diagnosis of follicular thyroid cancer had a sensitivity, specificity, positive predictive value, and accuracy of 67%, 100%, 100%, and 96%, respectively. In most cases (64%), FS rendered no additional information at the time of operation. Therefore, the cost per useful FS was $7800, which is higher than the charge of a completion thyroidectomy (approximately $6000). Conclusions: FS analysis for follicular lesions seems to be highly specific and accurate. However, because of the low sensitivity, routine use of FS is not cost-effective in patients with follicular thyroid lesions.

Original languageEnglish (US)
Pages (from-to)94-98
Number of pages5
JournalAnnals of Surgical Oncology
Volume11
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Keywords

  • Fine-needle aspiration
  • Follicular thyroid lesions
  • Frezen section
  • Thyroidectomy

ASJC Scopus subject areas

  • Surgery
  • Oncology

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