Thyroid papillary microcarcinoma: A descriptive and meta-analysis study

Institute of Endocrinology, University of Milan, 20133 Milan, Italy.
European Journal of Endocrinology (Impact Factor: 4.07). 09/2008; 159(6):659-73. DOI: 10.1530/EJE-07-0896
Source: PubMed


The authors review anatomical, clinical characteristics and prevalence of thyroid microcarcinoma. Diagnostic procedures and risk factors of aggressiveness at diagnosis and during follow-up are also covered. The possible clinical, pathologic and therapeutic risk factors are analyzed by meta-analysis study. Treatment procedures by different authors and guidelines suggested by societies are reported.

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Available from: Ettore degli Uberti, Feb 18, 2014
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    • "We then investigated the presence of a correlation between histopathological findings and serum leptin levels. In WDTC, the size of the primary tumor, multifocality, and lymph node status are essential criteria in risk stratification into either low risk or high risk and will predict disease recurrence [27, 28]. Although trends were demonstrated between leptin levels and each of tumor size (p = 0.079), malignant lymph node involvement (p = 0.48), and multifocal disease (p = 0.064), the differences did not reach statistical significance. "
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    ABSTRACT: Background There is a proven relationship between obesity and several cancers including breast, endometrium, colorectal, and esophagus. With the increasing incidence of both obesity and thyroid cancer, we designed the present study to investigate a causal relationship between leptin, which is one of the well known adipokines, and well-differentiated thyroid cancer (WDTC). Methods Serum leptin levels were measured in 30 patients with WDTC and compared to 30 healthy control subjects before and 1 month after surgery. Other parameters studied included age, sex, body mass index, menopausal status in women, lymph node status, tumor size, and disease multifocality. Results There were no differences between the two groups regarding age and sex. Preoperative leptin levels were higher in the WDTC patients when compared to the control patients [19.25 (1.50–109.60) vs 0.90 (0.50–11.80) ng/ml, p < 0.001, group 1 vs group 2, respectively]. A significant drop in leptin levels 1 month after surgery occurred in the WDTC group, falling from 19.25 (1.50–109.60) to 0.90 (0.60–8.90) ng/ml (p < 0.001). This did not occur in the control group (p = 0.274). Lymph node involvement, tumor size, and multifocality had no effect on leptin levels, although trends were observed (p = 0.48, 0.079, and 0.064), respectively. Conclusions Serum leptin levels were significantly higher in WDTC patients when compared to control group patients, with a significant drop after surgery. Leptin may play a role in diagnosis of WDTC; however, its prognostic value is still undetermined.
    European Journal of Surgical Oncology 05/2014; 38(10). DOI:10.1007/s00268-014-2634-8 · 3.01 Impact Factor
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    • "Multifocality and extra-thyroidal extension were associated with an increased risk of lymphatic metastasis including the laterocervical area [28] [31] and a higher mortality rate and neoplastic relapse [32]. The risk of tumour recurrence varies in the case of multifocality from 1% to 2% in unicentric papillary micro carcinoma, 4e6% in multifocal papillary micro-carcinoma [33] [34], 8e10% in >4 cm intra-thyroidal PTC [35]. In our study, analysis of variance revealed that only extra-capsular extension may be considered a predictor of relapse. "
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    ABSTRACT: Aims of the study: The aim of this retrospective study was to appraise the impact of central neck dissection (CND) when treating papillary thyroid carcinoma (PTC) and identifying predictors of tumour recurrence by analysing the results and complications related to this surgical procedure. Materials and methods The study examined the histories of 347 patients with PTC, divided into two groups: group A including 284 patients who underwent total thyroidectomy (TT) only; group B including 63 patients who underwent TT and CND and possible lateral neck dissection (LND). Results The patients in the B group were younger than those in the A group (an average of 44.5 vs. 48.6; p = 0.03) and their tumours were larger (1.91 cm vs 1.27 cm, p = 0.001). Multifocality, extra-capsular extensions of the neoplastic mass and high cell histological variant were more prevalent in the B group. The incidence of permanent hyperparathyroidism was higher in group B than in group A (25.4% vs 9.5%, p = 0.0006). Recurrence of disease and the numbers requiring reoperation were also higher in group B: (24.1% in group B vs 6.6 in group A, p <0.0001). Patients classified as clinically N0 at their first operation and who were most probably clinically N1, totalled 6.6%. Conclusions Our data show that only extra-capsular extension may be considered a predictor of recurrence. The findings of our study support the idea of carrying out "therapeutic" CND only in cases of preoperative or macroscopic intraoperative clinical evidence of lymph-node involvement.
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    • "It is mostly diagnosed in patients who have undergone surgery for benign diseases of the thyroid gland [29] [30]. In a study, 71% of the papillary thyroid microcarcinomas were incidentally diagnosed in patients undergoing surgery for benign diseases [31]. Incidental papillary thyroid microcarcinoma rates are reported as 3.1% and 21% respectively in two other studies [32] [33]. "
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    ABSTRACT: Selection of multinodular goiter (MNG) surgery procedure is stilll under discussion. Subtotal thyroidectomy (STT) and neartotal thyroidectomy (NTT) are preferred surgical procedures. However, it is uncertain whether the remnant tissue contains pathological findings or not after these procedures. We aimed to evaluate and comparison the pathologic findings in remnant tissue after NTT and STT. Thyroid tissue samples of 50 patients who underwent TT for MNG disease between January 2010 and August 2011 in our clinic were evaluated. Before the dissection of the thyroid tissue subtotal and neartotal margins were marked in both right and left lobes. After the resection of the specimen, the tissue was excised from the subtotal and neartotal margin marked during the surgery. The pathologic findings of the main tissue, the residual subtotal and neartotal tissues were evaluated and compared. All patients were followed-up 1 year. 43 (86%) females and 7 (14%) males with an average age of 50.5 (23-77) were included in the study. Incidental papillary thyroid cancer was detected in 5 patients (10%). Pathologic findings were present in 31 patients (62%) of subtotal residual tissue and 28 of the patients (56%) of neartotal residual tissue. Papillary microcarcinoma was detected in 3 (9.7%) of subtotal residual tissues and 2 (7.1%) of neartotal residual tissues. There is no significant difference between subtotal and neartotal tissues in terms of existence of pathological findings (p>0.05). There is no significant difference between the neartotal and subtotal residual tissues contralateral of dominant nodule (p>0.05). 2 of the patients (4%) had temporary hypocalcemia, 1 patient (2%) had seroma and 1 patient (2%) had recurrent laryngeal nerve injury. There are high rates of microscopic pathological findings on residual tissues both after STT and NTT. The neartotal and subtotal residual tissues contralateral to the large nodule also had high levels of pathologic findings.
    International Journal of Clinical and Experimental Medicine 11/2013; 6(10):922-929. · 1.28 Impact Factor
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