ECE2014 Poster Presentations Endocrine tumours and neoplasia (99 abstracts)
Should unifocal papillary thyroid microcarcinoma be treated as much radically as multifocal one?
Anna Guminska 1 , Elwira Bakula-Zalewska 2 , Malgorzata Benke 1 , Elzbieta Bruszewska 1 , Malgorzata Czetwertynska 1 , Joanna Dlugosinska 1 , Anna Garszel 1 , Paulina Godlewska 1 , Emilia Musial 1 , Joanna Niewiadomska 1 & Marek Dedecjus 1
1Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska – Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; 2Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska – Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
Introduction: Multifocal papillary thyroid microcarcinama (PTmC) has been considered as more aggressive than the unifocal one.
Aim of the study: This paper aims to compare this two groups considering histopatological sign of aggressivity, presence of inflammation and radioiodine uptake.
Materials and methods: The analysis concerned 81 patient with microcarcinoma (PTmC) selected from group of 961 (8%) diagnosed and treated in conventional way because of thyroid carcinoma. Patients were divided into three groups: S – one focus, diameter ≤10 mm (n=45); MS – multifocality, total diameter ≤10 mm (n=22); MB – multifocality, total diameter >10 mm (n=14). Histopatology, level of anti-thyroglobulin antibody (a-TG) and radioiodine uptake were analized.
Results: Sensivity of FNAB was significantly lower in MS as compared to S or MB. Percentage of cases with capsule’s infiltration, angioinvasion and neck nodular metastases was the most highest in S respectively (62, 36, 11), MS (27, 18, 5) and MB (36, 7, 7). In multifocal cases capsule’s infiltration occurred more often in MB while angioinvasion was more frequent in MS. Both groups were similar in respect of neck nodular metastases’ presence. Presence of increased a-TG level was similar in S and MB but less frequent in MS while mean a-TG level was the highest in MS and lower but comparable in S and MB. Radioiodine uptake was comparable in all groups.
Conclusions: i) Inspite of the fact, that multifocality is believed to be associated with increased malignancy in analized group the signs of invasiveness were significantly more frequently observed in unifocal PTmC.
ii) Multifocality alone rather than total focuses’ diameter should be considered as a potential indicator of increased risk of invasiveness of PTmC.
iii) Relatively high incidence of multifocality may justify total thyroidectomy as a treatment of PTmC.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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