Thyroidectomy during Pregnancy and Correlated Complications

Objective: to analyze unanimously diagnostic and surgical outcomes in the patients with thyroid cancer treated with minimally invasive techniques. Methods: Between November 2010 and February 2011, all the pregnant patients diagnosed as thyroid cancer cases were included in the study. During pregnancies, the nodule doubled in size in all of the patients. The fine needle aspiration (FNA) was performed in all study subjects to detect malignancy. Overall, seven patients underwent thyroidectomy, while six patients underwent subtotal thyroidectomy or lobectomy. Subtotal thyroidectomy was performed in two patients during second trimesters, whereas other study subjects underwent surgery following 4 to 11 months of childbirth. Three patients reported lumps within their necks during their 1st pregnancy, which remained in place up to 18 months and were further investigated during their 2nd pregnancy. The planned treatment for these patients was delayed due to prevailing pregnancy, and the treatment was carried out after 24 months of first appearance of nodules. Results: Patients were clinically evaluated and serum thyroglobulin levels were measured at each visit. Four study subjects received radioiodine ablation (3 GBq), with two of them receiving two additional therapeutic doses (14 GBq) because of lymph node involvement. Following the surgery, the patients were given sufficient doses of thyroxine for suppressing the levels of thyrotropic hormone (TSH). The average time spent on follow-ups was 6.5 years. Thyroid cancer regressed in lymph nodes of neck in 2 patients during this time, and they were handled with modified neck dissection after radioiodine and they fully cured after three years. Bone metastases formed after 1.5 years of thyroidectomy in the 3 patients who received delayed treatment, and they died following 5 years. In total, 12 of the 13 patients are fully cured and alive, with normal serum thyroglobulin levels. Then, seven babies were born to 8 of these patients.