Papillary thyroid microcarcinoma: A study of 900 cases observed in a 60-year period

Hay, Ian D.; Hutchinson, Maeve E; Gonzalez-Losada, Tomas; McIver, Bryan; Reinalda, Megan E.; Grant, Clive S.; Thompson, Geoffrey B.; Sebo, Thomas J.; Goellner, John R.

doi:10.1016/j.surg.2008.08.035

Cited by 709 publications

(690 citation statements)

References 22 publications

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“…As mentioned earlier, most papillary microcarcinomas follow an indolent clinical course. 5,6 However, there have been an increasing number of reports of aggressive papillary microcarcinomas. Papillary microcarcinomas may present with up to 35% multifocality, 24 up to 30% lymph node metastasis, 3 up to 28% extrathyroidal extension 3 and up to 2% distant metastases.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is the most common form of papillary carcinoma, 1 comprising almost half of the papillary thyroid carcinomas reported in recent studies. [2][3][4] Most papillary microcarcinomas remain silent and have a slow clinical course, but some behave aggressively, with local recurrence [5][6][7] and early distant metastasis, 5,7 giving rise to clinically significant disease. Furthermore, a papillary microcarcinoma may occasionally be the primary lesion of a lymph node metastasis presenting clinically as a neck mass.…”

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confidence: 99%

“…8 Although its clinical significance in papillary microcarcinomas is somewhat controversial, several authors have reported that lymph node metastasis at presentation is correlated with loco-regional recurrence in papillary microcarcinomas. 5,[9][10][11] Moreover, lymph node metastasis is reported to be associated with distant metastasis of papillary microcarcinomas. [9][10][11] In the new TNM (tumor, node, metastases) staging system, lymph node metastasis is a more important factor than tumor size in overall staging.…”

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confidence: 99%

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S100A4 expression is associated with lymph node metastasis in papillary microcarcinoma of the thyroid

et al. 2008

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The detection of papillary microcarcinomas of the thyroid is increasing due to frequent use of ultrasound and fine-needle aspiration biopsy. Although most of the papillary microcarcinomas remain quiescent and follow an indolent clinical course, some behave aggressively and metastasize early, giving rise to clinically significant disease. There have been few studies concerning factors predictive of lymph node metastasis in papillary microcarcinomas. We analyzed the expression of S100A4, cyclin D1, p27 and MUC1, the presence of the BRAF V600E mutation and the clinicopathological features of the tumors, including patient age, tumor size (Z5 vs o5 mm), extrathyroidal extension, multifocality, histological subtype, sclerosis and encapsulation, in a series of 198 papillary microcarcinomas in relation to lymph node metastasis to determine the predictive factors of lymph node metastasis. On univariate analysis, tumor size of 5 mm or more, extrathyroidal extension, multifocality, sclerosis and the expression of S100A4 and cyclin D1 predicted lymph node metastasis, whereas patient age, expression of p27 and MUC1 and the BRAF V600E mutation did not. Moreover, tumor size 5 mm or more, multifocality and expression of S100A4, especially its strong expression in the invasive fronts, were significantly associated with macrometastasis and lateral node metastasis. On multivariate analysis, multifocality and expression of S100A4 were found to be common independent predictive factors of lymph node metastasis, macrometastasis and lateral node metastasis. In conclusion, S100A4 expression in papillary microcarcinomas may indicate the presence of nodal metastasis. Thus, S100A4 immunohistochemistry may be valuable for predicting metastatic potential in papillary microcarcinomas.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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S100A4 expression is associated with lymph node metastasis in papillary microcarcinoma of the thyroid

et al. 2008

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“…It is well-known that PTMC may show multicentricity in 15-44% of the cases, and regional lymph node metastasis may be found in 14-64% of the cases (Hay et al, 1992;Lin et al, 1997;Rodriguez et al, 1997;Rassael et al, 1998;Sugitani and Fujimoto, 1999;Chow et al, 2003;Falvo et al, 2003). These are two important clinical features, and the nodules are non-palpable, therefore difficult to detect on physical examination.…”

Section: Usefulness Of Us-fnab In Malignant Thyroid Micronodulesmentioning

confidence: 99%

Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

Ünal

Sezer²

2014

Asian Pacific Journal of Cancer Prevention

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Background: The diagnostic approach to thyroid nodules involves ultrasound-guided fine needle aspiration biopsy (US-FNAB).We especially aimed to evaluate the contribution and the place of US-FNAB in preoperative evaluation of the malignant cases and draw attention to discordant cases diagnosed with papillary thyroid microcarcinoma (PTMC). Materials and Methods: A total of 276 cases were retrospectively reviewed who were subsequently diagnosed with a malignancy and who underwent US-FNAB. Results: Some 45 were found to have previously undergone the US-FNAB procedure. Of the patients in whom the surgical specimen was diagnosed with a malignancy, 21 (46.7%) were diagnosed as malignant or suspicious for malignancy, and 24 (53.3%) were concluded as benign or insufficient for diagnosis. Patients with the diagnosis of PTMC outnumbering the others was a striking finding (11 cases, 24%). Conclusions: We suggest performing repeat aspiration biopsy considering sampling errors in cases where inconsistency exists between clinical findings and cytological results in thyroid nodules smaller than 10 mm in diameter and with suspicious findings on ultrasonography.

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“…Thyroid microcarcinomas are defined as carcinomas B1 cm in size [1,2]. In a large retrospective study, total thyroidectomy was demonstrated to decrease recurrence and improve survival in patients with papillary thyroid cancer (PTC) exceeding 1 cm, but not in patients with PTC B 1 cm [3].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Frozen Biopsy of Central Lymph Node in the Management of Papillary Thyroid Microcarcinoma

Lee

Yoon

Kim

et al. 2015

Indian J Otolaryngol Head Neck Surg

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The purpose of this study was to evaluate the usefulness and accuracy of intraoperative frozen section examination in the diagnosis of metastatic central lymph nodes in comparison to the final histopathological findings. A retrospective review was performed to evaluate patients with a preoperative diagnosis of papillary thyroid microcarcinoma (PTMC) and a plan to perform thyroid lobectomy at our Hospital from September 2011 to September 2013. Sixteen patients were identified. Intraoperative frozen section examination diagnosed ten patients as negative malignant cells of the central lymph node and the remaining six patients as metastatic central lymph node. The final histopathological results corresponded with intraoperative frozen section examination. Intraoperative frozen section examination had a sensitivity, specificity and accuracy of 100 % for diagnosing metastatic central lymph nodes of PTMC. Intraoperative frozen section examination of central lymph nodes is a useful and accurate adjunct for determining the operation method in PTMC.

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Papillary thyroid microcarcinoma: A study of 900 cases observed in a 60-year period

Cited by 709 publications

References 22 publications

S100A4 expression is associated with lymph node metastasis in papillary microcarcinoma of the thyroid

S100A4 expression is associated with lymph node metastasis in papillary microcarcinoma of the thyroid

Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

Intraoperative Frozen Biopsy of Central Lymph Node in the Management of Papillary Thyroid Microcarcinoma

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