Papillary Microcarcinoma

Abstract

Background Papillary microcarcinoma (PMC) is increasing in incidence because of diagnosis by ultrasound-guided fine-needle aspiration cytology. Methods Between January 1966 and December 1995, we treated 6019 patients with papillary cancer; among them, 2070 patients with PMC were studied. Results PMC is essentially very similar to papillary cancer that is 11 mm or larger and has a very good prognosis. Smaller tumors and younger patients have a better prognosis. Among PMC, larger tumors (6-10 mm) recur in 14% at 35 years compared with 3.3% in patients with smaller tumors. Patients older than 55 years have recurrence in 40% at 30 years, with a worse prognosis than younger patients who have a recurrence rate of less than 10%. Extracapsular invasion by the primary tumor also has a higher recurrence rate. The majority of recurrences are in the neck. Therefore, annual ultrasound of the neck is effective for recurrence surveillance. Conclusion Papillary microcarcinoma is similar to larger papillary carcinomas with tumor characteristics and agebased recurrence rate that extends for many years, justifying long surveillance after surgery.

Thyroid nodules and evaluation of thyroid cancer risk

“…Importantly, the ATA Guidelines recognise that nodules < 1 cm rarely harbour clinically significant cancer and do not routinely require evaluation because of the low cost benefit ratio. However some small nodules, especially those > 0.5 cm, may be considered for FNAB if they are associated with abnormal lymph nodes on palpation or imaging at presentation, ‘high risk’ history, focal avidity on PET scanning or suspicious ultrasound features 2 , 18 . Guidelines from the American Association of Clinical Endocrinologists and Society of Radiologists in Ultrasound similarly use suspicious ultrasound findings to recommend FNAB although their size criteria differ from the ATA Guidelines 1 , 2 , 13 .…”

Incidental finding of papillary thyroid carcinoma on CT examination of mandibular lesion: Case report

“…In addition, the ratio of malignant and benign was higher in younger patients, although age was not an independent predictor of PTMC (10,11,13).…”

“…Both benign and malignant tumors demonstrated intermediate signal intensity on T1WI and high signal intensity on T2WI, even if in our case showed high signal intensity in T1WI and STIR. Additional investigations are required to determine malignancy such us US or FNA (7,(9)(10)(11).…”

“…On PTC case size and patient age are important for treatment consideration. Some study of PTC has grouping PTC based on size (2,7,10,11,13). PTC with <5 mm known as papillary thyroid microcarcinoma (PTMC), in elderly patients, progressivity of lesion was not evident during observation and immediate surgery was not needed (4,11,13).…”

“…Tanpitukponse et al reported only a small proportion of incidental finding of thyroid lesions from CT and MRI examinations that were referred from radiologists to clinicians, had undergone additional examination (14). Patient age and nodule size influenced clinicians to make decisions regarding additional examination (6,11,(13)(14)(15). Hoang et al reported that 2 cm is the threshold size of CT and MR examinations for incidental finding of thyroid lesion (6).…”