Surgical Anatomy of the Pyramidal Lobe (Lobe of Lalouette): A Tertiary Care Cancer Centre Experience.

Surgical Anatomy of the Pyramidal Lobe (Lobe of Lalouette): A Tertiary Care Cancer Centre Experience.

Int J Surg. 2016 May 10;

Authors: Irawati N, Vaish R, Chaukar D, Deshmukh A, D'Cruz A

Abstract
INTRODUCTION: To study the characteristics of pyramidal lobe (PL) in cancer patients with emphasis on its involvement in patients subjected to thyroidectomy at a tertiary care cancer centre.
METHODS: Retrospective review of prospectively maintained data of 103 patients (33 males and 70 females) who underwent thyroidectomy from January 1(st) 2011 - August 31(st) 2013. Surgery was performed by single surgeon, findings recorded by the lead author and all measurements taken with specimen in situ prior to mobilization of thyroid gland with intact anatomy. Thyroid specimens were examined for presence, location, length and histology of PL.
RESULTS: PL was identified in 38 (36.89%) of patients. PL was commoner on left 27 (71.05%) compared to 11 (28.95%) on right side. The frequency of PL was higher in males 51.51% compared to females 30%. The length varied from 4 to 35 mm. The mean length was 18.0±12.4 mm. In 10.53% cases PL contained deposits of papillary carcinoma of thyroid.
DISCUSSION: Meticulous clearance of disease is of utmost importance in thyroid cancer surgery in order to prevent recurrence and ensure reliable follow up with serum thyroglobulin. PL is a common site of residual thyroid tissue which if involved by cancer can be a cause of local recurrence.
CONCLUSIONS: PL is a well established entity which is present in over one third of patients. Efforts should be made to identify PL during surgery given its bearing on the management of thyroid carcinoma as one third of these will be site of multifocal papillary carcinoma.

PMID: 27177982 [PubMed - as supplied by publisher]

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