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[Papillary microcarcinoma of the thyroid]
F Leprat1, H Trouette, C Cochet
1Service d'endocrinologie et maladies métaboliques, Hôpital Haut l'Evèque, Bordeaux-Pessac.
Annales D'Endocrinologie
|January 1, 1994
Summary
Papillary microcarcinoma, often considered low-grade, can show aggressive behavior with extra-thyroidal spread. Some cases necessitate total thyroidectomy and radioiodine ablation for effective treatment.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Context:
- Thyroid differentiated carcinoma treatment remains debated.
- Papillary microcarcinoma (< 1 cm) is frequently diagnosed incidentally.
- These tumors often present in extra-nodular thyroid parenchyma.
Purpose:
- To analyze the clinical behavior and prognosis of papillary microcarcinoma.
- To evaluate the diagnostic and therapeutic implications of incidental papillary microcarcinoma findings.
Summary:
- A study of 49 papillary microcarcinoma cases revealed a high incidence (51% of differentiated carcinomas).
- Despite small size (median < 2 mm), 8% showed extra-thyroidal extension, including lymph node and bone metastasis.
- Multifocal disease and peripheral invasion suggest a heterogeneous prognosis, challenging limited surgical approaches.
Impact:
- Findings suggest some papillary microcarcinomas require more aggressive treatment than typically administered.
- Highlights the need for careful consideration of total thyroidectomy and radioiodine remnant ablation in specific cases.
- Emphasizes the potential for unexpected metastasis even in small papillary thyroid cancers.