The surgeon’s estimation of fibrosis-sclerotic alteration in the thyroid. Part 1

Introduction. Intraoperative macroscopic assessment of thyroid diseases is difficult. Fibrosclerotic alterations in the thyroid gland may be found in its benign diseases as well as in malignant neoplasms. The non-specificity of these alterations creates difficulties for the final decision on the extent of surgery. The purpose of the study. To evaluate the clinical significance of fibrosclerotic alterations in the thyroid gland based on literature data. Materials and methods of research. Search for literature data in the E-library database using the keywords “fibrosis”, “sclerosis”, “calcification”, “hyalinosis”, “thyroid gland". Treatment results. Increase of the thyroid stromal connective tissue is a frequent reason for macroscopically seen structural changes and hormonal shifts. The fibrosis and hyalinosis in benign thyroid diseases is a factor for hypothyroidism. The fibrosis, hyalinosis, sclerosis and calcification are the signs of an irreversible transformation with a high probability of tumor and probably is a risk factor of its aggressiveness. Nevertheless, fibrosclerotic alterations in the thyroid gland is not an obligatory sign of a malignant process. Moreover, on morphological examination the process often turns out to be benign. However, the presence of fibrosclerotic alterations is an additional factor for making a decision about the increase of the extent of surgery. Conclusion. Modern diagnostic methods make it possible to diagnose thyroid disease morphologically with a high degree of accuracy before surgery. However, in the presence of local or widespread thyroid fibrosis, the surgeon must decide a question about the extent of surgery intraoperatively. The intraoperative ultrasound examination can facilitate this task.