Papillary thyroid microcarcinoma: incidence and prognostic factors

Abstract

The objective of this study was to define the prognostic factors of papillary microcarcinoma of the thyroid (PMCT), and to analyse their epidemiologic and histopathologic characteristics. Our series included 57 patients diagnosed with PMCT between 1994 and 2003 among 944 patients who underwent thyroid surgery. All the surgical specimens were examined in the same department of pathology using the same technique. The prognostic factors were elaborated from the results of the histological examination. The epidemiological and histopathological characteristics were also evaluated. Two sub-groups were distinguished: patients with node disease and/or with metastasis (17 patients) and patients without node disease and metastasis (40 patients). The architecture of PMCT was papillary in 14% of cases, follicular in 35% of cases and mixed in 49% of cases, with no significant difference between any two groups. Histopathologic characteristics such as the vascular extension, infiltration into the adjacent parenchyma or in the thyroid capsule are all indicative of a poor prognosis. Two categories of PMCT, with and without the risk of metastatic spread, can be identified from these prognostic factors.

Multifocality and Total Tumor Diameter Predict Central Neck Lymph Node Metastases in Papillary Thyroid Microcarcinoma

“…4,10,36,38,[41][42][43] In contrast, in studies in which multifocal or all PTMC patients were given central neck dissection, there was no statistical difference in local recurrence between multifocal and unifocal tumors. 22,25,27,44 Routine neck dissection eliminates the possibility of residual micrometastases in high-risk cases with LNM, which may explain the above phenomenon.…”

A Risk Model for Predicting Central Lymph Node Metastasis of Papillary Thyroid Microcarcinoma Including Conventional Ultrasound and Acoustic Radiation Force Impulse Elastography

“…Histopathological characteristics such as the vascular infiltration, extension to the adjacent parenchyma or the thyroid capsule, multiple foci, are all associated with metastatic spread, which may explain the above-mentioned results. 34,35 …”

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

“…Total/near total thyroidectomy was carried out in 100% of the cases in 17 (11,12,14,15,18,24,26,27,39,46,49,52,97,104,106,117,150) out of 44 studies that reported the type of surgery (4-6, 8, 11, 12, 14-18, 20, 23-27, 30-32, 34, 38-40, 42, 45, 46, 48-50, 58, 97, 98, 104-106, 114, 117, 121, 123, 124, 143, 148, 150). Combining the results of different studies that clearly reported the extent of surgery in 9259 patients with PTMC, total/near total thyroidectomy was performed in the 72%, subtotal thyroidectomy in the 11% and lobectomy in the 17% of the cases (4-6, 8, 11, 12, 14-18, 20, 23-27, 30-32, 34, 38-40, 42, 45, 46, 48-50, 58, 97, 98, 104-106, 114, 117, 121, 123, 124, 143, 148, 150).…”