Endocrine Abstracts

Introduction: Thyroid papillary microcarcinoma is a subtype of papillary carcinoma that included tumors with less than 10 mm diameter. Its therapeutic management is still a subject of controversy.

Material and Methods: We conducted a retrospective study over 20 cases of papillary thyroid microcarcinoma at the ENT department of Tahar Sfar Hospital in Mahdia over 17 years (2000–2017).

Results: We report 20 cases of papillary thyroid microcarcinoma occuring in 18 women and 2 men. The mean age was 42 years ranging from 24 years to 75 years. A family history of thyroid pathology was noted in three cases and no prior history of cervical radiation or thyroid surgery was found. The ultra sound of the neck showed benign thyroid nodules in 18 cases and lateral lymph node associated to a suspect infracentimetric nodule in two cases. Lymph node metastases of papillary carcinoma were detected by fine needle aspiration cytology in these two cases. Total thyroidectomy was performed for 8 cases of multinodular goiters, thyroid lobectomy for 10 cases of a thyroid nodule. The intra operative pathologic examination was benign for these cases. Total thyroidectomy associated to central and lateral lymph node dissection was undergone in two cases. All the cases of thyroid microcacinoma were found during final pathologic examination. Lymph node metastases were noted in nine cases. Completion thyroidectomy following lobectomy that was associated to a central lymph node dissection was performed for 8 cases. Two cases of lobectomy did not perform this procedure since the size of microcacinoma was successively 1 and 2 mm. Radio-active Iodine remnant ablation treatment was indicated in 15 patients: 9 cases of lymph node metastases, extra thyroidal invasion in 5 cases and bilateral microcarcinoma in one case. A six years mean follow-up revealed no recurrence or death.

Conclusion: Papillary thyroid microcarcinoma have favourable long-term prognosis. Its management is multidisciplinary. A controversy exists regarding the role of radioactive iodine remnant ablation in this type of tumor. The indication of it depends on histological data.