Endocrine Abstracts

Background: Papillary microcarcinoma (PMC) of the thyroid is defined as papillary thyroid carcinoma (PTC) measuring ≤1 cm., Survival after surgery for papillary thyroid microcarcinoma is greater than 99%. The chances of a recurrence of thyroid cancer after surgery are between 2-4%.

Case Presentation: 9 years old boy was consulted by an endocrinologist in 2012. 6-5-1 mm thyroid nodule revealed. Thyroid antibodies and thyroid hormones were in normal ranges. He was administered 100 mg of iodine supplementation. An ultrasound examination of the thyroid gland was performed once in 6 months. In 2016, the isoechoic nodule of 9 x 6 mm, with microcalcifications was determined. FNA was performed-papillary carcinoma was detected. A total thyroidectomy was planned. Histomorphological examination of the postoperative material confirmed the presence of papillary microcarcinoma Radioiodine therapy was not performed. Thyroglobulin level was within the desired range after surgery and annually <0.2 ng/ml 2016-2021. Thyroid hormone levels were maintained within the recommended target range of 0.5-2.0 ng/ml. In 2023 an increase in TG, anti-TG, and the presence of pretracheal lymph nodes with reduced echogenicity were detected. An aspiration biopsy with cytological examination of the lymph node was performed - a secondary lesion of papillary carcinoma. On June 9, 2023, the patient underwent reoperation and radioiodine therapy.

Conclusions: After total thyroidectomy, long-term follow-up was conducted for more than 5 years with positive results. Nevertheless, in the process of observation, a tendency of TG increase was revealed, not within the limits of the recommendations >1 ng/ml, which did not indicate the risk of disease recurrence. However, with additional studies conducted, tumor metastasis was discovered and excised in time