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Incidentally discovered papillary thyroid microcarcinoma in patients undergoing thyroid surgery for benign disease

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Abstract

Introduction

The incidence of thyroid carcinoma has grown significantly over the last few decades. A possible explanation is the increased diagnosis of small thyroid microcarcinoma (TMc). TMc reach a maximum diameter of ≤1 cm, identified during histopathology examination following a thyroidectomy performed for reasons not pertaining to malignancy. This study aims to investigate the prevalence of papillary thyroid microcarcinoma (PTMc) according to the benign pathology that refers patients to surgery and its trend evolution.

Methods

Retrospective cohort analysis of 1815 patients who underwent total thyroidectomy for non-malignant diseases in the 2005–2020 period.

Results

The mean age of the subjects was 53.5 years, with a higher proportion of women (1481, 82.1%). A total of 167 PTMc (9.3%) were incidentally discovered. A multivariate logistic regression analysis was performed, showing no differences in prevalence according to sex or age in patients with PTMc compared to final benign histology. Multinodular goiter increases the risk of PTMc with an odds ratio of 2.2 (p = 0.001) compared to Hashimoto’s thyroiditis and Graves’ disease (GD). There is a statistically significant increase in the incidence of PTMc in the group operated in the 2017–2020 vs. 2005–2008 period (p = 0.005).

Conclusion

The overall prevalence of PTMc in patients who underwent thyroid surgery for the benign disease was 9.3%. Thyroid nodular hyperplasia was the most frequent benign pathology associated with PTMc compared to Hashimoto’s or GD. Gender and age were not correlated with the prevalence of TMc. Over the years, surgical findings of PTMc have grown, particularly in the 2017–2020 period.

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Acknowledgements

The authors would like to thank the Surgery, Pathology, Radiology, Nuclear Medicine, and Endocrinology Department at Hospital Universitario de Navarra for the support provided in treating patients.

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Authors and Affiliations

  1. Endocrinology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain

    Joaquín de Carlos, Ander Ernaga, Jose Javier Pineda & Emma Anda

  2. Section of Endocrinology, Hospital García Orcoyen, Estella, Navarra, Spain

    Ana Irigaray

  3. Pathology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain

    Ana Echegoyen

  4. General Surgery Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain

    Pilar Salvador

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  1. Joaquín de Carlos
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  2. Ander Ernaga
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Contributions

J.d.C. was in charge of analysis, writing up the article, and interpreting the data. A. Ernaga was responsible for overseeing the project, data collection, and manuscript correction. A.I. was responsible for the data analysis, data collection, and its critical revision. J.J.P. was responsible for follow-up patients, data acquisition, and intellectual production. A. Echegoyen was responsible for the histological study of the sample and study designs. P.S. was responsible for surgery, literature search, and follow-up of patients. E.A. coordinated the study. All authors discussed previous versions of the manuscript and agreed to the submission of the final version.

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Correspondence to Joaquín de Carlos.

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All authors have completed the ICMJE uniform disclosure form. The authors have no conflicts of interest to declare.

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Ethical principles for medical research involving human subjects under the World Medical Association Declaration of Helsinki have been conducted. The study protocol has been approved by the ethics committee of the Government of Navarre (Spain). This study has been granted an exemption from requiring written informed consent by the ethics of the Government of Navarre (Spain).

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de Carlos, J., Ernaga, A., Irigaray, A. et al. Incidentally discovered papillary thyroid microcarcinoma in patients undergoing thyroid surgery for benign disease. Endocrine 77, 325–332 (2022). https://doi.org/10.1007/s12020-022-03089-6

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