Microcarcinoma da tireóide: experiência e conduta em clínica privada

Abstract

RESUMO), e 313 a iodoterapia (94,27%). Tivemos metástase a distância em 5 pacientes (1,5%). Após 1 ano, de 170 pacientes submetidos à PCI, temos 141 considerados livres de doença, 21 com anti-tireoglobulina positivo, 6 com tireoglobulina superior a 2 ng/ml, sendo 1 com metástase pulmonar e outro com recidiva linfonodal (0,3%). Conclusão: Recomendamos que seja realizada a tireoidectomia total, esvaziamento cervical de necessidade e iodoterapia ablativa na presença de fatores clínicos e anátomo-patológicos de risco. Objective: The study of papillary microcarcinoma observed during the thyroidectomies in our private clinic. Material and methods: We reviewed clinical and histopathological results of 1,930 consecutive patients submitted for thyroidectomies in the period from 2002 to 2006, 606 had thyroid carcinomas but only 332 were papillary microcarcinoma. We studied gender, age, histologic type, size, multifocality, frequency of neck dissection, and results of Whole Body Scan and thyroglobulin. Results: Overall, we found 48 males and 146 older than 45 years old. Therapy included total thyroidectomy for all, therapeutic neck dissection in 19 (5.72%), and radioiodine for 313 (94.27%). We found 5 patients with distant metastases (1.5%). After 1 year, from 170 submitted to WBS, we consider 141 free of disease, 21 have positive thyroglobulin antibody, 6 have thyroglobulin level above 2 ng/ml, being 1 with lung metastases and other with lymph node recurrence (0.3%). Conclusion: We recommend total thyroidectomy, therapeutic neck dissection and radioiodine ablation when present clinical and pathological risk factors.