[Differentiated microcarcinoma of the thyroid gland]

The thyroid microcarcinoma is a tumor with maximum diameter of 10 mm (WHO). For the most part is not clinically palpable and not evident by imaging investigations. The papillary microcarcinoma is the most common form of thyroid cancer, followed by follicular microcarcinoma. The aim of our study is to assess the frequency of microcarcinoma, the association of benign thyroid disease himself and the controversial surgery.

We analyzed 391 patients (321 F and 70 M) who underwent total thyroidectomy from 2004 to 2009 at a Unit of General Surgery, Uremic and Organ Transplant, Hospital of Palermo.

42 carcinomas were detected, of which 24 PTMC and 1 follicular microcarcinoma. The PTMC was associated with cancer in only 2 cases (papillary carcinoma and parathyroid carcinoma) in the remaining thyroid tissue was suffering from benign disease (20 goiters, 3 Hashimoto thyroiditis, a trabecular adenoma). TALK: Controversial is still the type of surgery to be performed in case of differentiated thyroid microcarcinomas, as well as the indication is still debated to lymphadenectomy.

Papillary microcarcinoma of the thyroid in our series, represents 57% of all thyroid cancers. Microcarcinoma and benign thyroid disease association (76.92% of cases) was high. The therapeutic attitude adopted by us was total thyroidectomy associated with conservative lymphadenectomy in the presence of palpable lymph nodes, instead to abstaining in the absence of clinical evidence of nodal metastases.