Abstract
Papillary thyroid microcarcinoma (PTMC) is a common malignant disease of the endocrine system, which has rapidly increased in incidence and prevalence in recent decades. The aim of our paper was to identify correlations between pathological and clinical features of cases of PTMC. A total of 612 patients of both genders, who were operated on for benign thyroid diseases in the 3rd Surgical Unit of St. Spiridon University Hospital of Iasi, were monitored for a period of 2 years. According to pathological reports, PTMC was diagnosed in 144 cases. Of those cases, 81.2% were female and 18.8% were male, with an overall mean age of 54.77 ± 11.9 years. The mean diameter of tumors was 3.04 ± 2.2 mm (75.7% were under 5 mm), and 35.4% were multifocal tumors. Of all tumors studied, 76.4% were the follicular variant, 13.2% were conventional, and 10.4% of cases included tall cell, hobnail, or columnar variants. The underlying diseases were multinodular goiters (73.6%), adenomas (25%), Hashimoto thyroiditis (17.4%), Basedow’s disease, and other types of hyperthyroidism (4.9%), primarily hyperparathyroidism (7.6%), with a small percentage presenting a combination thereof. Extracapsular invasion was present in 14.6% while 5.6% presented perineural invasion and 0.7% of cases had vascular invasion. Lymphatic emboli were found in 9% of cases and lymph node metastasis in 5.6% of cases. PTMC is not as innocent as believed, and further studies, performed on larger batches, would be necessary in order to identify high oncological risk cases and to determine when a more aggressive surgical approach is indicated.
Highlights
Papillary thyroid microcarcinoma (PTMC) is defined as papillary thyroid carcinoma (PTC)measuring less than 1 cm at its largest diameter [1]
The inclusion criterion was the presence of PTMC in the final pathological report for patients with an initial diagnosis of benign thyroid disease, whereas patients in whom other types of thyroid carcinoma were concomitantly discovered were excluded
As the percentage of incidental PTMC in our cohort was higher, our results agree with two other studies that reported that PTMC in histological specimens after thyroid surgery for benign diseases was found in 22% and 27.4% of cases, respectively [15,17]
Summary
Papillary thyroid microcarcinoma (PTMC) is defined as papillary thyroid carcinoma (PTC). Measuring less than 1 cm at its largest diameter [1]. In most cases PTMC has a steady state or is very slow growing with a low rate of metastasis, and based on those characteristics it is considered to have a very good prognosis [2]. We should not neglect the fact that it is still a carcinoma and a small percentage of patients do not have such good prognoses, due to development of lymph nodes or distant metastases. Given the morbidity associated with thyroidectomy, which cannot be decreased under 1–3%, even in specialized centers [3], extensive surgical treatment for all cases of diagnosed.
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