Abstract
The presented follow up revealed, that in 5146 consecutive strumectomies, 1745 (33.9%) intraoperative frozen sections have been performed: screening these cases, the highest incidence of frozen sections occurred in malignant strumas and atypical adenomas with 79.6 and 70.2% respectively. In benign goiters, intraoperative microscopical examination was done in 27.6% of the cases.The surgeon faces problems with false negative (23 patients) and false positive (2 patients) frozen sections, as well as with the so-called “borderline” cases, i.e. when the pathologist can not distinguish benign from malignant tumors. While the pathologist is relieved of his responsibility, the surgeon has to choose the operative procedure, avoiding unnecessary thyroidectomy, nevertheless performing unilateral lobectomy in order to facilitate a reoperation, if malignancy is finally proven. These cases are analysed and discussed in detail.91.3% intraoperative diagnosis of frozen section were accurate. Especially in tumors without preoperative fine needle aspiration or clinically suspected malignancy, the surgeon has to make an intraoperative assessment during operation. Relying on his own and the pathologist's experience he should make a generous use of intraoperative frozen section. In most cases, this procedure can best assure a correct decision and spare the patient a reoperation.
Published Version
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