Endocrine Abstracts

Objective

The study’s purpose is to describe the therapeutic management of papillary thyroid microcarcinoma.

Material and methods

This is a retrospective study including 55 cases of papillary thyroid microcarcinoma treated at our department, from 2000 to 2020.

Results

Our study included 8 men and 47 women. The mean age was 48.64 years with extreme ages from 24 to 73 years old. Three patients had hypothyroidism, one patient had hyperthyroidism and two had a history of loboisthmectomy for benign nodules. No personal history of cervical irradiation or thyroid cancer in the family have been noted. The average consultation delay was 14 months. The circumstances of discovery were: lateral cervical lymph node metastases in 5 cases, incidentally discovered by histological examination of the thyroidectomy specimens in 51 cases and ultrasound-guided fine-needle aspiration in 4 cases. The surgical procedure towards the gland was total thyroidectomy in 47 cases, loboisthmectomy in 6 cases and lobectomy in 2 cases (totalization). Central lymph node dissection was performed in 42 cases and 5 patients had lateral lymph node dissection. The postoperative course was complicated by: lymphorrea in 1 case, hematoma in 1 case, transient hypocalcaemia in 5 cases, transient recurrent laryngeal nerve paralysis in 3 cases. The mean size of microcarcinomas was 5 mm [1 mm–10 mm]. Microcarcinoma was multifocal in 16 cases, non-encapsulated in 28 cases and with extra thyroid extension in 12 cases. Fifteen patients had central lymph node metastasis and lateral lymph node involvement was noted in 5 cases. None of the patients had distant metastasis. Radioactive iodine has been indicated in 42 cases with a dose ranging from 100 mCi to 400 mCi. Thyroid hormone suppression was indicated in all cases. After a mean follow up of 3 years and 6 months, 2 patients presented a recurrence. Five patients were lost to follow-up.

Conclusion

The incidence of papillary thyroid microcarcinoma is increasing. Its therapeutic management, which must be multidisciplinary, is still a controversial subject. It remains an entity with a good.