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Micromedullary thyroid cancer: how micro is truly micro?
Venu G Pillarisetty1, Steven C Katz, Ronald A Ghossein
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Annals of Surgical Oncology
|July 2, 2009
Summary
Sporadic micro-medullary thyroid cancer (MTC) tumors less than 0.5 cm show no lymph node metastasis or elevated calcitonin. These findings suggest completion thyroidectomy may not be necessary for small MTCs.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Medullary thyroid cancer (MTC) often presents with lymph node (LN) metastases.
- The clinical significance of small, sporadic MTCs (≤1 cm) remains unclear.
Purpose of the Study:
- To define the clinical significance of sporadic micro-medullary thyroid cancer (MTC).
- To evaluate the risk of lymph node metastasis and elevated calcitonin in small MTCs.
Main Methods:
- Retrospective review of clinical, laboratory, and pathologic data for 18 patients with sporadic micro-MTC.
- Analysis of tumor size, LN metastasis, and postoperative calcitonin levels.
Main Results:
- Tumors ≤0.5 cm showed no clinical evidence of LN metastases.
- Elevated postoperative calcitonin levels were only observed in patients with tumors between 0.7-0.9 cm.
- No deaths occurred during a median follow-up of 3.3 years.
Conclusions:
- Sporadic micro-MTCs <0.5 cm are associated with an absence of clinically detectable nodal disease and normal postoperative calcitonin.
- The lack of multifocal or bilateral disease in these small tumors suggests completion thyroidectomy is not indicated.
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