Aims: To determine the changing trends and current role of surgery for the management of thyroid lymphoma.
Methods: A retrospective review of 50 surgical patients with a final diagnosis of thyroid lymphoma over a 35-year period.
Results: All patients presented with an enlarging mass, with half having compressive symptoms on presentation. Two-thirds of patients had co-existent histological features of Hashimoto's thyroiditis. Surgery for patients with thyroid lymphoma peaked in the late 1970s (0.79% of all thyroid operations performed) followed by a significant decline in the 1980s with a current frequency of only 0.16% (p=0.009). A larger number of thyroid resections intended as a curative procedure was performed during the first half of this series compared to the latter half (p=0.05). There was no difference in disease-free survival between patients treated by thyroid resection when compared with an open biopsy (p=0.4875).
Conclusion: The surgical management of thyroid lymphoma has changed with time. Currently a larger proportion of patients are undergoing surgery in order to achieve a histological diagnosis rather than with therapeutic intent, however, an important role for surgery still exists in the management of a patient with severe airways obstruction.