Multicentricity in thyroid papillary microcarcinomas

Abstract

Purpose: In this study we aimed to determine, the multcentricity rates in patients with papillary microcarcinoma and the surgical method that should be applied.

Materials and Methods: A total of 1818 patients underwent thyroid surgery and we evaluated 379 patients retrospectively, who were reported to have thyroid cancer histopathologically. In these patients, 137 patients with papillary microcarcinoma were determined. We reviewed medical records of patients, for mulicentricity and frequency of microcarcinoma. Patients were classified according to MACIS, EORTC and TNM classification systems for thyroid cancer.

Results: Thirty-three (24%) of 137 patients with papillary microcarcinoma were detected to be multicentric. In 7 (21%) there were two or more tumor foci. The incidence of cancer was 33% in the other lobe when there was more than one foci in the same lobe. In all patients preoperative ultrasonography of the thyroid gland was multinodular. Ultrasonographic findings suspicious for malignancy were sought and in 44% patients these findings were present. Fine needle aspiration biopsy was performed in 31 patients and results of 23 patients were benign. Frozen section was performed 58 patients, where 17 patients had a benign frozen section report.

Conclusion: The risk of multicentricity in papillary microcarcinoma patients should be taken into account for determining the optimal surgical treatment. To prevent missing microcarcinoma foci, ultrasonography should be applied meticulously.