Incidental and nonincidental papillary thyroid microcarcinoma

Abstract
Background  Subtotal thyroidectomy or lobectomy without radioactive iodide (131I) treatment is sufficient for postoperative treatment of incidental papillary thyroid microcarcinoma (PTMC). Aggressive surgical
treatment with 131I therapy is indicated for nonincidental PTMC.

Methods  This is a retrospective analysis of 335 PTMC patients who received primary thyroid surgical treatment and long-term follow-up
in a single medical center. All PTMC patients were categorized as incidental (group I) or nonincidental (group II). Group
II patients (209 cases) were categorized as intrathyroid (group II A), neck lymph node or local regional soft-tissue invasion
(group II B) and distant metastasis (group II C) groups.

Results  In group I, 105 of 126 cases received only subtotal thyroidectomy or lobectomy. None died of thyroid cancer. Histological
evaluation revealed multicentric PTMC in 12 (9.5%) and 52 (24.9%) cases (P < 0.05) in groups I and II, respectively. In group II, 55 of the 209 patients (26.3%) presented with extrathyroidal involvement.
Two cases of relapse occurred in group I and 20 in group II by the end of follow-up. One patient in group II B and two patients
in group II C died of thyroid cancer. Nine out of ten patients in group II C were diagnosed with distant metastases before
primary thyroid surgical treatment.

Conclusion  Subtotal thyroidectomy is effective surgical treatment for incidental PTMC. For nonincidental cases, aggressive treatment
is essential for reducing the risk of cancer relapse or mortality following surgery.

Content Type Journal ArticleCategory Endocrine TumorsDOI 10.1245/s10434-008-9958-2Authors
Jen-Der Lin, Chang Gung University Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital 5, Fu-Shin St. Kweishan county Taoyuan Hsien Taiwan, R.O.C.Sheng-Fong Kuo, Chang Gung University Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital 5, Fu-Shin St. Kweishan county Taoyuan Hsien Taiwan, R.O.C.Tzu-Chieh Chao, Chang Gung University Department of General Surgery, Chang Gung Memorial Hospital Taoyuan Hsien Taiwan, R.O.C.Chuen Hsueh, Chang Gung University Department of Pathology, Chang Gung Memorial Hospital Taoyuan Hsien Taiwan, R.O.C.

Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)  MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.