Clinicopathological features and treatment of postsurgical incidental papillary thyroid microcarcinoma
10.3760/cma.j.issn.1674-6090.2015.01.008
- VernacularTitle:术后意外甲状腺微小乳头状癌的临床病理特点与治疗
- Author:
Meng YANG
;
Yao LU
;
Xin LI
;
Xiaoliang SUN
;
Linping HUANG
- Publication Type:Journal Article
- Keywords:
Thyroid;
Papillary Microcarcinoma;
Postsurgical incidental papillary thyroid microcarcinoma
- From:
Journal of Endocrine Surgery
2015;9(1):23-25
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze clinicopathologic features and treatment strategy of postsurgical incidental papillary thyroid microcarcinoma(PTMC).Methods A total of 305 patients undergoing surgery for thyroid diseases from Apr.2012 to Mar.2013 were retrospectively analyzed.Results Among the 305 patients,19 patients(18 females and 1 male)showed PTMC incidentally after surgery.The mean age was (43.2 ± 12.8)years (ranging from 23 to 67 years old).All patients underwent subtotal thyroidectomy,including 17 endoscopic surgery and 2 open surgery.All frozen sections were benign during operation while pathologic results were PTMC after surgery.The average size of tumors was(2.2 ± 1.5) mm which all was unicentric with no lymph node enlargement intraoperatively.Immunohistochemistry showed that the positive rate of cytokeratin 19,galectin-3,mesothelial cell,and CD56 was 87.5％,43.8％,81.3％ and 18.8％,respectively.There were 4 cases of B-raf V600E mutation found in 6 patients.All patients discharged 1 to 3 days after surgical treatment with no complication and received levothyroxine therapy with a suppressive dose of thyrotropin(TSH).131I therapy was not given.Conclusions PTMC is found more common in female and younger age under 45 years.Tumor is usually unicentric and less than 5 mm.Lymph node metastasis is rare.Immunohistochemistry and B-raf V600E mutant test can help the diagnosis.Initial endoscopic subtotal thyroidectomy is effective.There is no need of further surgery and 131I therapy.
