[Thyroid epitheliomas in French Polynesia]

The authors reviewed 34 cases of thyroid epithelioma registered in French Polynesia from 1985 to 1990. Annual incidence classifies French Polynesia as a region with low endemicity. The patients were 31 females and 3 males. In 18 cases, carcinoma was discovered within a multiheteronodular goitre (MHNG) and in 16 cases within an isolated nodule. In each of these sub-groups, 4 micropapilliform cancers discovered at the occasion of a histopathological test. The mean age of the patients carrying a noduliferous cancer is 36.5 years and the one of multiheteronodular goitre is 50. No particular risk factor was discovered. Mean age of the disease is 2.8 years as far as noduliferous cancers are concerned, and 8.5 years for multiheteronodular goitre. The anatomical and echographic characters are discussed. What demanded a surgery intervention is reviewed. Mortality during intervention is zero. Morbidity recorded 17% of unilateral recurrent paralysis and 50% of transitory parathyroid insufficiency. Extemporaneous anatomopathological test was contributing in 25% of the cases; definitive test revealed 25 (74%) papilliform cancers (of which 8 micropapilliforms) and 9 vesicular cancers (26%). No canceration anaplasia was discovered. Evolutive stage is precised: 7 local invasions (isthm and/or capsule), 4 bifocal localizations, 8 cancers with adenoid metastasis, 4 with osseous and/or pulmonary metastasis. The way to select a therapy is reported and discussed. Cost evaluation is suggested in order to discuss the possibility to acquire for the Territory an equipment for isotopic exams.