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[Our experience with papillary microcarcinoma of the thyroid]
R Garrel1, C Cartier, V Marvaso
1CHU Gui de Chauliac, Service d'ORL et Chirurgie Cervico-Faciale, Rue Augustin Fliche, F-34295 Montpellier, France. r-garrel@chu-montpellier.fr
Introduction:
Papillary microcarcinoma (PMC) of the thyroid gland is high incidence pathology. Most of cases are related to a good prognosis. Conversely, numerous cases are reported with an aggressive course. Prognosis factors are age, size of tumour, multifocality, capsular invasion and cervical lymphadenopathy.
Material And Method:
We have conduced a retrospective study about 4,208 consecutive thyroidectomies over a period of 16 years. 251 cases of papillary cancers were analysed including 64 PMC (25.5%).
Results:
90% of PMC were incidentally found and 59% were diagnosed during surgical procedure. Multifocality improved the sensibility of histological diagnosis (P = 0.04). In 78%, total thyroidectomy was performed associated with a selective neck dissection in 47%. In case of extemporaneous diagnosis all partial thyroidectomy was convert into total thyroidectomy. In case of delayed diagnosis and in the absence of unfavourable prognosis factor, no other surgical procedure was carried out. A 7 years mean follow-up revealed only one case of recurrence successfully treated with Iodine 131 ablation. There was no case of death due to PMC.
Conclusion:
This study confirms the good prognosis of PMC treated according to usual criterions.