J Surg Ultrasound.  2020 Nov;7(2):36-41. 10.46268/jsu.2020.7.2.36.

Role of Preoperative Staging Ultrasound for Papillary Thyroid Microcarcinoma

• Keum HJ
• Jung JH
• Kim WW
• Park HY
• Lee J

• KMID: 2511901
• DOI: http://doi.org/10.46268/jsu.2020.7.2.36

Abstract

Purpose
Papillary thyroid microcarcinoma (PTMC) has an excellent prognosis and can be managed with active surveillance or surgery, dependingon its location and numbers. The authors investigated the role of preoperative staging ultrasound for PTMC with statistical parameters.
Methods
This study included 159 patients with PTMC who underwent thyroidectomy at Kyungpook National University Chilgok Hospital. The tumor size of PTMC, location, bilaterality and multifocality, anterior or posterior aspect of ETE, and metastasis of central/lateral neck lymph nodes were assessed by preoperative thyroid ultrasound and compared with the pathology results. The statistical parameters were calculated and compared.
Results
The incidence of bilaterality of PTMC was similar in the ultrasound and pathology findings, and multifocalitywas identified in 27 cases (17.0%) and 35 cases (22.0%) in ultrasound and pathologic results, respectively. On the other hand, anterior and posterior ETE was identified only in 19 cases (11.9%) in the pathology findings,which was only approximately 50% of that in the preoperative ultrasound (36 cases, 22.6%). In the statistical parameters, most of the parameters were highest when evaluating metastatic lateral neck lymph node and lowest when evaluating metastatic central neck lymph nodes.
Conclusion
Preoperative ultrasound for PTMC was useful to assess the size of PTMC, multifocality, anterior or posterior ETE, and metastatic lateral neck lymph nodes. On the other hand, as it is difficult to predict a central neck lymph node metastasis, it would be better for the operator to consider additional surgery based on the intraoperative findings.

Keyword

Thyroid; Papillary microcarcinoma; Papillary microcarcinoma

Figure

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  Fig. 1 Various ultrasonographic findings of thyroid papillary microcarcinoma (PTMC). Extrathyroidal extension to anterior aspect (arrow head) (A) or to posterior aspect (arrow heads) (B), abutting status to trachea of PTMC can be detected in preoperative ultrasound. Multifocal (D) or bilateral (E) PTMCs can be also identified in ultrasound.

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  Fig. 2 Ultrasonographic findings of suspicious central neck lymph nodes (A, B, arrows) and lateral neck lymph nodes (C, D, arrow head) in thyroid papillary microcarcinoma (PTMC).

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