Papillary Thyroid Carcinoma Size;

Abstract

Background: Papillary thyroid carcinoma (PTC) is the most common malignancyof thyroid gland. It constitutes about 90% of all well differentiated thyroid carcinomas and has anindolent course with excellent prognosis.1,2,3 Death due to papillary thyroid carcinoma is rare andaccounts for only 0.2% of cancer deaths in United States of America.4 The prevalence of PTChas increased world over due to the wider use of ultrasonography and fine needle aspirationcytology (FNAC) in the routine diagnostic workup. Also papillary thyroid microcarcinomas(PTMC) are being increasingly diagnosed as incidental findings in thyroid gland removed forother thyroid pathologies, like follicular adenoma, multi-nodular goiter or diffuse goiter, etc. Dueto uncertainty for this tumor to metastasize to the regional lymph nodes, it is usually not clearwhether the surgeon should take the patient to the operating room and proceed with lymphnode dissection or to wait and observe. Study Design: In this retrospective study from the yearPeriod: January 2012 to January 2015, a total of 43 cases of total thyroidectomy with regionallymph node dissection and with histopathological diagnosis of papillary thyroid carcinomawere retrieved from archives of Setting: Charsada Teaching Hospital affiliated with JinnahMedical College Peshawar. The slides and diagnoses of all the retrieved cases were reviewed.Information regarding primary tumor size, any metastasis in regional lymph nodes, patient’sage and presence or absence of any associated thyroid disease was noted and analyzed.Results: The analysis of the 43 cases of PTC showed that papillary thyroid carcinoma was morecommon in females than males. It affected age groups between 10 and 80 years of age andwas most common in the 4th decade of life. Cervical lymph node metastasis was directly relatedwith the size of primary papillary thyroid carcinoma. The commonly associated thyroid diseasesincluded Hashimoto’s thyroiditis, followed by multinodular goiter and rarely Graves’ disease.Conclusions: Papillary thyroid carcinoma is more common in females; it affects patients in theirfourth decade of life and is commonly associated with Hashimoto’s thyroiditis. Moreover thechances of cervical lymph node metastasis are directly proportional to the primary tumor size.