Annals of Surgical Oncology

, 15:2287

Incidental and Nonincidental Papillary Thyroid Microcarcinoma

  • Jen-Der Lin
  • Sheng-Fong Kuo
  • Tzu-Chieh Chao
  • Chuen Hsueh
Endocrine Tumors

DOI: 10.1245/s10434-008-9958-2

Cite this article as:
Lin, J., Kuo, S., Chao, T. et al. Ann Surg Oncol (2008) 15: 2287. doi:10.1245/s10434-008-9958-2

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.

Keywords

Nearly total thyroidectomyThyroglobulinMulticentric131I treatmentFollicular variant of papillary thyroid carcinoma

Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Jen-Der Lin
    • 1
  • Sheng-Fong Kuo
    • 1
  • Tzu-Chieh Chao
    • 2
  • Chuen Hsueh
    • 3
  1. 1.Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial HospitalChang Gung UniversityTaoyuan HsienTaiwan, R.O.C.
  2. 2.Department of General Surgery, Chang Gung Memorial HospitalChang Gung UniversityTaoyuan HsienTaiwan, R.O.C.
  3. 3.Department of Pathology, Chang Gung Memorial HospitalChang Gung UniversityTaoyuan HsienTaiwan, R.O.C.