Endocrine Abstracts

Introduction: Patients with PTC usually have excellent outcomes with appropriate therapy, while up to 30% of patients present with aggressive disease, including patients with locoregional recurrence and distant metastasis.

The aim: Of this study is to analyze the characteristics of patients with papillary carcinoma of the thyroid with locoregional and distant recurrences.

Résults: We included 12 cases of locoregional and distant recurrence of papillary thyroid carcinoma. 10 of our patients are female and 2 are male with a sex ratio of 1/5. The majority of our female patients are younger than 55 years. The initial surgical treatment consisted of lobo-isthmectomy in one patient, total thyroidectomy in 9 of our patients and thyroidectomy with lymph node dissection in 2 cases. Five of our patients had a tumor size greater than 4 cm, in 3 cases the tumor size was between 2.1 cm and 4 cm, and in 4 patients it was less than 2 cm. In our series we noted multifocality in only one patient. Capsular invasion was observed in 6 patients, representing half of the cases. As for the aggressive histological type, we noted only one case of a patient with the oncocytic variant of papillary carcinoma on anatomical-pathological study. Two of our patients had lymph node metastasis in the cervical region at the time of diagnosis. None of our patients had distant metastasis at the time of diagnosis. In one case the ATA risk stratification of recurrence was in favor of a low recurrence risk. In 3 patients the risk of recurrence was intermediate and in 8 cases the risk of recurrence was high. All our patients received radioiodine therapy, 6 patients had received a single cure of radioiodine therapy, 4 patients had received two cures, only one patient had received 3 cures and one patient had received 4 cures of radioiodine therapy. Only one patient had received 2 lines of targeted therapy: sorafenib and sunitinib. Eight patients had locoregional lymph node recurrence alone, one patient had lymph node and lung metastasis, one case had lymph node and bone recurrence in the right sacroiliac joint. One case had a bone metastasis in the tibia. One case had pulmonary and bone metastases in the femur. During the follow-up period, none of our patients died.

Conclusions : Papillary thyroid carcinoma is an indolent disease, but cases having certain characteristics are likely to show recurrence and even become life-threatening.