[Management of microcancer]

Most of the papillary thyroid microcarcinomas have an excellent prognosis, though some of them, like macrocarcinomas, lead to local recurrences or distant metastasis. Detection of high risk factors to choose between conservative or aggressive treatment would be essential but is difficult and controversial, criterias being multiple. This is why we favour in most instances total or near total thyroidectomy with nodal dissection, morbidity of this surgery being very low. TSH suppression treatment is routinely advocated but not adjunctive radioiodine ablation. This approach authorizes an easier long term follow up.