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Predictive Factors for Occult Contralateral Carcinoma in Patients with Unilateral Papillary Thyroid Microcarcinoma by Preoperative Ultrasonographic and Pathological Features

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Abstract

Background

The surgical extent and indication for treatment in patients with papillary thyroid microcarcinoma (PTMC) remain a controversial issue. The aim of this study was to investigate the predictive factor for contralateral occult carcinoma in patients with unilateral PTMC by preoperative ultrasonographic and pathological features.

Methods

Of the total patients who underwent thyroidectomy, 455 patients with PTMC confined to one unilateral lobe as diagnosed using preoperative ultrasonography (US) were enrolled in the study. Occult contralateral carcinoma was defined as tumor foci in the contralateral lobe that was not detected preoperatively, but was detected pathologically. All patients underwent preoperative US review to investigate the US features of PTMC such as laterality, location, size, internal component, echogenicity, margin, calcification shape, multifocality, bilaterality, extrathyroidal extension, and location with respect to the trachea. Clinicopathological data were also analyzed.

Results

Of the total of 455 patients who underwent total thyroidectomy for preoperatively detected unilateral PTMC, 71 patients (15.6 %) had contralateral occult carcinoma. Clinicopathological characteristics did not significantly differ between patients with and without contralateral occult carcinoma. Multivariate analysis showed that the absence of a well-defined margin and the presence of a probably benign nodule in the contralateral lobe were independent predictive factors for contralateral occult carcinoma in patients with unilateral PTMC in preoperative US images.

Conclusion

We demonstrated that an absence of a well-defined margin and the presence of a probably benign nodule in the contralateral lobe were independent predictive factors for contralateral occult carcinoma in patients with unilateral PTMC in preoperative US. The prediction of contralateral occult carcinoma in unilateral PTMC using preoperative US features could be useful for determining the optical extent of surgery.

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Conflict of interest

No potential conflict of interest relevant to this article was reported.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea

    Young Chan Lee & Young Gyu Eun

  2. Department of Radiology, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea

    Yu-Mee Sohn

  3. Department of Endocrinology and Metabolism, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea

    Sang Youl Rhee, Suk Chon & Seung Joon Oh

  4. Department of Nuclear Medicine, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea

    Il Ki Hong & Deog Yoon Kim

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  1. Young Chan Lee
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Correspondence to Young Gyu Eun or Yu-Mee Sohn.

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Lee, Y.C., Eun, Y.G., Sohn, YM. et al. Predictive Factors for Occult Contralateral Carcinoma in Patients with Unilateral Papillary Thyroid Microcarcinoma by Preoperative Ultrasonographic and Pathological Features. World J Surg 39, 1736–1741 (2015). https://doi.org/10.1007/s00268-015-3024-6

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  • DOI: https://doi.org/10.1007/s00268-015-3024-6

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