Incidental micropapillary carcinoma in thyroidectomy specimens and criteria employed for Diagnosis - A Retrospective Study

Abstract

Incidental Papillary thyroid Microcarcinoma (I-PTM) is a tumor focus that is clinically unsuspected before thyroid surgery and is identified in the final pathological examination of a thyroidectomy specimen. Papillary thyroid Microcarcinoma has a benign behavior with excellent prognosis in most cases and therefore several controversies regarding the need for completion surgery for excision of remaining thyroid tissue and lymphnodes exist. A total of 22 patients with PTM incidentally diagnosed on postoperative histopathological examination of the excised thyroid tissue were analyzed for assessing the rate of incidental diagnosis of PTM and their demographic features and the surgical procedures used for their treatment. I-PTM was diagnosed in 13.6 % of males and 86% of females respectively. The average age in cases with I-PTM was 40 years (range 25 to 65 years). Of the 22 cases of I-PTM, 11 were operated with a pre-diagnosis of Multi nodular goitre and 8 were operated with a pre-diagnosis of solitary nodule (colloid nodule /follicular adenoma).Total thyroidectomy was performed in 11 cases,sub-total thyroidectomy was performed in 9 cases and right hemithyroidectomy was performed in 2 cases. In one case of I-PTM lower margin of excision was involved and was subjected for radioiodine therapy at referral centre.