Skip to main content
SpringerLink
Log in

Prevalence of papillary microcarcinoma of the thyroid in Brazilian autopsy and surgical series

  • Clinical Research
  • Published:
Endocrine Pathology Aims and scope Submit manuscript

Abstract

In order to search for parameters to differentiate patients at low and high risk for development of thyroid cancer, we studied thyroids from 166 consecutive autopsies and 261 thyroids that were surgically resected for thyroid diseases in general. We found 32 papillary microcarcinomas, corresponding to 7.8% of autopsies and 7.2% of surgical material, with a higher incidence between 30 and 49 yr of age. Both genders were similarly affected: 9.3% of the men and 8.8% of the women in autopsy series, and 6.2% of the men and 7.3% of the women in surgical series, suggesting that hormonal factors may favor the subsequent development of clinical lesions in women. Although associated nodular goiter has been observed in 54% of autopsies and 26% of surgical specimens, while Hashimoto's thyroiditis only in surgical material (15% of the cases), we were not able to correlate risk of malignancy with any concomitant lesion. The smallest papillary microcarcinomas presented most frequently as nonencapsulated nonsclerosing tumors without inflammatory infiltrate or fibrosis, suggesting that they may represent the early stages of development. Our data show a relatively high and similar frequency of papillary microcarcinomas in surgical and autopsy series, but do not demonstrate risk factors for clinical evolution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pelizzo MR, Bernante P, Toniato A, Fassina A. Frequency of thyroid carcinoma in a recent series of 539 consecutive thyroidectomies for multinodular goiter. Tumori 83:653–655, 1997.

    PubMed  CAS  Google Scholar 

  2. Sachmechi I, Miller E, Varatharajah R, et al. Thyroid carcinoma in single cold nodules and in cold nodules of multinodular goiters. Endocr Pract 6:5–7, 2000.

    PubMed  CAS  Google Scholar 

  3. Mellemgaard A, From G, Jorgensen T, Johansen C, Olsen JH, Perrild H. Cancer risk in individuals with benign thyroid disorders. Thyroid 8:751–754, 1998.

    PubMed  CAS  Google Scholar 

  4. From G, Mellengaard A, Knudsen N, Jorgensen T, Perrild H. Review of thyroid cancer cases among patients with previous benign thyroid disorders. Thyroid 10:697–700, 2000.

    Article  PubMed  CAS  Google Scholar 

  5. Zardo F, Soldo P, Altissimi G, Parnasi E, Bertin S. Hashimoto's thyroiditis and thyroid cancer: a report of a clinical case and review of the literature. G Chir 20:174–176, 1999.

    PubMed  CAS  Google Scholar 

  6. Singh B, Shaha AR, Trivedi H, Carew JF, Poluri A, Shah JP. Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery 126:1070–1076, 1999.

    Article  PubMed  CAS  Google Scholar 

  7. Souza SL, Assumpção LVM, Ward LS. Impact of previous thyroid autoimmune diseases on prognosis of patients with well-differentiated thyroid cancer. Thyroid 13:491–495, 2003.

    Article  PubMed  Google Scholar 

  8. Chow SM, Law SC, Au SK, et al. Changes in clinical presentation, management and out-come in 1348 patients with differentiated thyroid carcinoma: experience in a single institute in Hong Kong, 1960–2000. Clin Oncol 15:329–336, 2003.

    Article  CAS  Google Scholar 

  9. Harach HR, Franssila KO, Wasenius V. Occult papillary carcinoma of the thyroid. A “normal” finding in Finland. A systemic autopsy study. Cancer 56:531–538, 1985.

    Article  PubMed  CAS  Google Scholar 

  10. Franssila KO, Harach HR. Occult papillary carcinoma of the thyroid in children and young adults: a systemic autopsy study in Finland. Cancer 58:715–719, 1986.

    Article  PubMed  CAS  Google Scholar 

  11. Lang W, Borrusch H, Bauer L. Occult carcinomas of the thyroid: evaluation of 1020 sequential autopsies. Am J Clin Pathol 40:72–76, 1988.

    Google Scholar 

  12. Martinez-Tello FJ, Martinez-Cabruja R, Fernandez-Martin J, Lasso-Oria C, Ballestin-Carcavilla C. Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods. Cancer 71:4022–4029, 1993.

    Article  PubMed  CAS  Google Scholar 

  13. Hefer TH, Joachims HZ, Hashinonai M, Bem-Arieh Y, Brown J. Highly aggressive behaviour of occult papillary thyroid carcinoma. J Laryngol Otol 109:1109–1112, 1995.

    PubMed  CAS  Google Scholar 

  14. Nogushi S, Yamashita H, Murakami N, Nakayama I, Toda M, Kawamoto H. Small carcinoma of the thyroid. A long-term follow-up of 867 patients. Arch Surg 131:187–191, 1996.

    Google Scholar 

  15. Fink A, Tomlinson G, Freeman JL, Rosen IB, Asa SL. Occult micropapillary carcinoma associated with benign follicular thyroid disease and unrelated thyroid neoplasms. Mod Pathol 9(8):816–820, 1996.

    PubMed  CAS  Google Scholar 

  16. Mitselou A, Vougiouklakis T, Peschos D, Dallas P, Agnantis NJ. Occult thyroid carcinoma. A study of 160 autopsy cases. The first report for the region of Epirus-Greece. Anticancer Res 22:427–432, 2002.

    PubMed  Google Scholar 

  17. Ward LS. Epidemiologia do câncer da tiróide no Brasil: apontando direções na política de saude do pais. Arq Bras Endocrinol Metabol 49:474–476, 2005.

    PubMed  Google Scholar 

  18. Bisi H, Fernandes VS, de Camargo RY, Koch L, Abdo AH, de Brito T. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma. Cancer 64:1888–1893, 1989.

    Article  PubMed  CAS  Google Scholar 

  19. Sobrinho-Simões MA, Sambade MC, Gonçalves V. Latent thyroid carcinoma at autopsy: a study from Oporto, Portugal. Cancer 43:1702–1706, 1979.

    Article  PubMed  Google Scholar 

  20. Bondeson L, Zeherlund B. Malignant thyroid carcinoma at autopsy in Malmo, Sweden. Cancer 47:319–323, 1981.

    Article  PubMed  CAS  Google Scholar 

  21. Yamamoto Y, Toshiharu M, Izumik, Otsuka H. Occult papillary carcinoma of the thyroid. A study of 408 autopsy cases. Cancer 65:1173–1179, 1990.

    Article  PubMed  CAS  Google Scholar 

  22. Bisi H, Ruggeri GB, Longatto Filho A, de Camargo RY, Fernandes VS, Abdo AH. Neoplastic and non-neoplastic lesions in autopsy material: historical review of six decades in São Paulo, Brazil. Tumori 84:499–503, 1998.

    PubMed  CAS  Google Scholar 

  23. Coeli CM, Brito AS, Barbosa FS, Ribeiro MG, Sieiro APAV, Vaisman M. Incidence and mortality from thyroid cancer in Brazil. Arq Bras Endocrinol Metabol 49:503–509, 2005.

    PubMed  Google Scholar 

  24. Rosai J, LiVolsi VA, Sobrinho-Simoes M, Williams ED. Renaming papillary microcarcinoma of the thyroid gland: the Porto proposal. Int J Surg Pathol 11:249–251, 2003.

    PubMed  Google Scholar 

  25. Barbaro D, Simi U, Meucci G, Lapi P, Orsini P, Pasquini C. Thyroid papillary cancers: microcarcinoma and carcinoma, incidental cancers and non-incidental cancers—are they different diseases? Clin Endocrinol (Oxf) 63:577–581, 2005.

    Article  CAS  Google Scholar 

  26. Hefer TH, Joachims HZ, Hashinonai M, Bem-Arieh Y, Brown J. Highly aggressive behaviour of occult papillary thyroid carcinoma. J Laryngol Otol 109:1109–1112, 1995.

    PubMed  CAS  Google Scholar 

  27. Livolsi VA. Highly aggressive behaviour of occult papillary thyroid carcinoma. J Laryngol Otol 110:710, 1996.

    PubMed  CAS  Google Scholar 

  28. Livolsi VA, Saavedra JA. Papillary carcinoma. In: De Lellis RA, Lloyd RV, Heitz PU, Eng C, eds. World Health Organization. Classification of tumours. Pathology & genetics of tumours of endocrine organs. Lyon, IARC Press, 2004; 57–66.

    Google Scholar 

  29. Casella C, Fusco M. Thyroid cancer. Epidemiol Prev 28:88–91, 2004.

    PubMed  Google Scholar 

  30. Memon A, Berrington De Gonzalez A, Luqmani Y, Suresh A. Family history of benign thyroid disease and cancer and risk of thyroid cancer. Eur J Cancer 40:754–760, 2004.

    Article  PubMed  CAS  Google Scholar 

  31. Ron E, Lubin JH, Shore RE, et al. Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies. Radiat Res 141:259–277, 1995.

    Article  PubMed  CAS  Google Scholar 

  32. Memon A, Varghese A, Suresh A. Benign thyroid disease and dietary factors in thyroid cancer: a case-control study in Kuwait. Br J Cancer 86:1745–1750, 2002.

    Article  PubMed  CAS  Google Scholar 

  33. Fukunaga FH, Yatani R. Geographic pathology of occult thyroid carcinomas. Cancer 36:1095–1009, 1975.

    Article  PubMed  CAS  Google Scholar 

  34. Franssila KO, Harach HR. Occult papillary carcinoma of the thyroid in children and young adults. A systemic autopsy study in Finland. Cancer 58:715–719, 1986.

    Article  PubMed  CAS  Google Scholar 

  35. Pino Rivero V, Guerra Camacho M, Marcos Garcia M, et al. The incidence of thyroid carcinoma in Hashimoto's thyroiditis. Our experience and literature review. An Otorrinolaringol Ibero Am 31:223–230, 2004.

    PubMed  CAS  Google Scholar 

  36. Hirabayashi RN, Lindsay S. The relation of thyroid carcinoma and chronic thyroiditis. Surg Gynecol Obstet 121:243–252, 1965.

    PubMed  CAS  Google Scholar 

  37. Okayasu I. The relationship of lymphocytic thyroiditis to the development of thyroid carcinoma. Endocr Pathol 8:225–230, 1997.

    PubMed  Google Scholar 

  38. Burstein DE, Nagi C, Wang BY, Unger P. Immunohistochemical detection of p53 homolog p63 in solid cell nests, papillary carcinoma, and Hashimoto's thyroiditis. A stem cell hypothesis of papillary carcinoma oncogenesis. Hum Pathol 35:465–473, 2004.

    Article  PubMed  CAS  Google Scholar 

  39. Souza SL, Assumpção LVM, Ward LS. Impact of previous thyroid autoimmune diseases on prognosis of patients with well-differentiated thyroid cancer. Thyroid 13:491–495, 2003.

    Article  PubMed  Google Scholar 

  40. Gupta S, Patel A, Folstad A, et al. Infiltration of differentiated thyroid carcinoma by proliferating lymphocytes is associated with improved disease-free survival for children and young adults. J Clin Endocrinol Metab 86:1346–1354, 2001.

    Article  PubMed  CAS  Google Scholar 

  41. Knobel M, Barca MF, Pedrinola F, Medeiros-Neto G. Prevalence of anti-thyroid peroxidase antibodies in autoimmune and nonautoimmune thyroid disorders in a relatively low-iodine environment. J Endocrinol Invest 17:837–842, 1994.

    PubMed  CAS  Google Scholar 

  42. Tomimori E, Pedrinola F, Cavaliere H, Knobel M, Medeiros-Neto G. Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid 5:273–276, 1995.

    Article  PubMed  CAS  Google Scholar 

  43. Innocencio RM, Romaldini JH, Ward LS. Thyroid autoantibodies in autoimmune diseases. Medicina (B Aires) 64:227–230, 2004.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology School of Medicine (FCM), State University of Campinas (UNICAMP), Sao Paulo, Brazil

    Patrícia Sabino de Matos MD, PhD & Ana Paula C. Ferreira MD

  2. Laboratory of Cancer Molecular Genetics, School of Medicine (FCM), State University of Campinas (UNICAMP), Sao Paulo, Brazil

    Laura S. Ward MD, PhD

Authors
  1. Patrícia Sabino de Matos MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ana Paula C. Ferreira MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura S. Ward MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrícia Sabino de Matos MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sabino de Matos, P., Ferreira, A.P.C. & Ward, L.S. Prevalence of papillary microcarcinoma of the thyroid in Brazilian autopsy and surgical series. Endocr Pathol 17, 165–173 (2006). https://doi.org/10.1385/EP:17:2:165

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1385/EP:17:2:165

Key Words

Search

Navigation