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Papillary thyroid microcarcinoma: a surgical perspective
George H Sakorafas1, John Giotakis, Vania Stafyla
1Department of Surgery, 251 Hellenic Air Force Hospital, Arkadias 19-21, GR-11526 Athens, Greece. georgesakorafas@yahoo.com
Cancer Treatment Reviews
|July 12, 2005
Summary
Papillary thyroid microcarcinoma (PTMC), the most common thyroid cancer, is increasingly detected by ultrasonography. Total thyroidectomy is favored for PTMC management due to its advantages and multifocal nature.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Papillary thyroid microcarcinoma (PTMC) is defined as papillary thyroid cancer ≤10mm.
- It is the most common thyroid cancer, with detection rates up to 36% in autopsy studies.
- Increased use of neck ultrasonography has led to higher PTMC detection rates.
Purpose of the Study:
- To discuss the diagnosis and management of PTMC.
- To highlight the advantages of total or near-total thyroidectomy for PTMC.
- To review adjuvant therapies and prognostic factors for PTMC.
Main Methods:
- Diagnosis relies on clinical examination, lab tests, and neck ultrasonography with fine-needle aspiration cytology.
- Surgical management often involves total or near-total thyroidectomy.
- Central neck lymph node dissection is considered electively for PTMC with lymphadenopathy.
Main Results:
- PTMC is frequently multifocal and often found incidentally.
- Total or near-total thyroidectomy is the preferred surgical approach in clinical practice.
- Radioiodine ablation and suppression therapy are used as adjuvant treatments.
Conclusions:
- PTMC generally exhibits benign biological behavior with a very good prognosis.
- Total thyroidectomy is recommended for PTMC, even for incidental findings or nodular thyroid disease.
- Prognostic factors guide the selection of patients for adjuvant radioiodine therapy.