J Korean Surg Soc.  2009 Jun;76(6):348-354. 10.4174/jkss.2009.76.6.348.

Clinicopathologic Findings of Micropapillary Carcinomas, according to Tumor Size

• Yoo YS
• Kim SS
• Mun SP
• Kim KJ
• Chang JH
• Min YD
• Kim SH
• Cho HJ
• Kim KC

• KMID: 1464949
• DOI: http://doi.org/10.4174/jkss.2009.76.6.348

Abstract

PURPOSE: Papillary thyroid microcarcinomas (PTMC), which are not palpable and have no clinical symptoms are 1.0 cm or less in diameter. The optimal extent of thyroid tumor resection has been controversial. We investigated clinicopathological findings of PTMC of 5 mm or less in diameter for reasonable therapeutic approach.
METHODS
From, Jan. 2002 to Dec. 2006, 366 patients underwent thyroidectomy for thyroid papillary carcinoma at our institution. Among these patients, 62 patients with a mass measuring less than 5 mm and 103 patients with a mass 5 mm to 1.0 cm were selected. We retrospectively reviewed their medical records.
RESULTS
There was no significant difference on the clinical characteristics except multifocality. We performed more unilateral lobectomy, near total thyroidectomy with or without neck node dissection in patients with PTMC of less than 5 mm (P=0.13). In permanent biopsy, lymph node metastasis more frequently occurred in patients with PTMC of less than 5 mm (P=0.03). There were no differences in capsular invasion, distant metastasis or recurrence.
CONCLUSION
In papillary thyroid microcarcinoma less than 0.5 cm, it is very uncommon for capsular invasion, distant metastasis and locoregional metastasis to exist. The extent of tumor resection may be limited less than near total thyroidectomy for suitable cases, because there was no locoregional metastasis or distant metastasis in the follow-up period. Longer follow-up periods would be required to confirm that limited surgery is sufficient for tumors less than 0.5 cm in size.

Keyword

Papillary thyroid carcinoma; Papillary thyroid microcarcinoma; Tumor size

MeSH Terms

Biopsy
Carcinoma
Carcinoma, Papillary
Follow-Up Studies
Humans
Lymph Nodes
Medical Records
Neck
Neoplasm Metastasis
Recurrence
Retrospective Studies
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Carcinoma
Carcinoma, Papillary
Thyroid Neoplasms

Figure

• 

  Fig. 1 The total number of papillary carcinoma and micropapillary carcinoma.

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