Clinical Features and Prognosis of Patients with Benign Thyroid Disease Accompanied by an Incidental Papillary Carcinoma

Abstract

Purpose: To investigate the clinical features and prognosis of papillary thyroid carcinoma (PTC) with a background of benign disease. Method: A total of 709 patients with papillary thyroid carcinoma undergoing surgical resection were analyzed retrospectively. In 147 patients who underwent surgery for benign thyroid disease, incidental PTC (IPC group) were identified by intraoperative or postoperative pathological examination of surgical specimens but were not detected by preoperative imaging studies. In the other group, according to the pathological examination with or without co-existing benign thyroid disease, 253 cases were clarified as concomitant PTC and 309 cases were clarified as dominant PTC. Results: Incidental PTC was more common in women, about 85.7%, the mean age was 47.6±11.3 years old. Average tumor diameter was 4.4±2.2 mm, multiple lesions accounted for 12.9% (19/147), and the cervical lymph node metastasis rate was 6.1% (9/147). After radical resection 8 cases recurred, the median time of recurrence was about 12 months (0.5 to 162), there was no tumor-related death. The tumor-free survival rates were 97.3%, 95.9%, 91.5%, and 79.3% in 1, 5, 10 and 14 year respectively. Conclusion: Incidental PTC with a background of benign lesions is common, and the generally good prognosis can be attributed to tumor early detection and early treatment. On the intraoperative finding of incidental PTC, lobectomy (unilateral) or total thyroidectomy (bilateral) should be the first choice, but with a postoperative pathologic finding of incidental PTC, further treatment, such as completion thyroidectomy or immediate lymph dissection is not necessary. Central lymph node dissection is also not needed unless lymphadenectasis is present.

Evolutionary features of thyroid cancer in patients with thyroidectomies from 2008 to 2013 in China

“…Our analysis suggests that for male patients with younger age (<45 years old), more attention may be needed to be paid as the risk of LNM in this group of patients is high. There has been a major area of controversy that whether these sub-centimeter PTCs needed to be treated as crPTC4041. Some investigators advocated in favor of not performing further treatment in addition to initial thyroid surgery and some even suggest to remove the cancer label from indolent lesions242, whereas others suggested an aggressive surgical approach followed by radioiodine ablation therapy40.…”

Histopathological Patterns of Thyroid Disease in Al-Madinah Region of Saudi Arabia

“…Our findings also conform to the recent registry based studies from Finland (Hakala et al, 2012) and Wales (Amphlett et al, 2013); regarding the increasing trend of papillary carcinoma in Europe. Wang et al, (2013) in their study found incidental papillary carcinoma in 147 out of their 709 cases and concluded that these are more common in females.…”

Contrast‐Enhanced Ultrasound Differentiation Between Low‐ and High‐ Grade Bladder Urothelial Carcinoma and Correlation With Tumor Microvessel Density

“…Angiogenesis, the process of new blood vessel development, is crucial for further growth of the tumor, and local extension and metastasis of multiple tumor types such as thyroid carcinoma, breast cancer, and bladder cancer. [7][8][9] Microvessel density (MVD), a measure of tumor angiogenesis and a reference standard in the quantification of blood vessels, is an important prognostic factor associated with survival in patients with bladder cancer. 10 However, determining MVD requires surgical and biopsy specimens that are prone to sampling errors.…”