scholarly journals Incidental Papillary Thyroid Microcarcinoma in an Endemic Goiter Area

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Emin Gürleyik ◽  
Gunay Gurleyik ◽  
Banu Karapolat ◽  
Ufuk Onsal
Keyword(s):  
Histopathological Examination ◽  
Blood Chemistry ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Pathologic Features ◽  
Suppressive Dose ◽  
Multifocal Disease ◽  
Thyroid Capsule ◽  
Capsule Invasion

Clinical and pathological characteristics of incidental papillary thyroid microcancer cases, surgical, medical, and nuclear treatment methods, and patients’ outcome were studied during follow-up period of 102 months. We studied 37 patients with incidental papillary thyroid microcancer (I-PTM). The surgical procedure was total thyroidectomy in 29 and hemithyroidectomy in 8 patients. Size, multifocality, and bilateralism of PTM foci, thyroid capsule invasion, and presence of lymphovascular invasion were histopathological parameters. We analysed adjuvant medical and nuclear treatment and patients’ outcome during follow-up period of 102 (61–144) months. The prevalence rates of I-PTM were 9.4% in 395 thyroidectomy cases. Histopathological examination reported unifocal disease in 30 and multifocal disease in 7 (18%) patients. Multifocal disease was bilateral in 6 (20.1%) patients. The mean size of the PTM foci was 4.88 mm. The rate of thyroid capsule invasion was 5.4%. All patients received a suppressive dose of LT4 to achieve a low serum TSH level. Adjuvant surgical and nuclear treatment was not performed in our cases. We did not find any negative changes in blood chemistry and ultrasound imaging, and any unfavourable events as locoregional and systemic recurrence. In conclusion, diagnosis of I-PTM is common that multifocality and bilateralism appear as pathologic features. The prognosis is excellent after surgical treatment and TSH suppression. Routine adjuvant nuclear treatment is unnecessary in majority of patients.

US-guided Microwave Ablation of Low-Risk Papillary Thyroid Microcarcinoma: Longer-Term Results of a Prospective Study

2020 ◽  
Vol 105 (6) ◽  
pp. 1791-1800 ◽  
Author(s):  
Wen-Wen Yue ◽  
Lu Qi ◽  
Dan-Dan Wang ◽  
Shou-Jun Yu ◽  
Xi-Ju Wang ◽  
...  
Keyword(s):  
Prospective Study ◽  
Distant Metastasis ◽  
Microwave Ablation ◽  
Large Population ◽  
Low Risk ◽  
Papillary Thyroid Microcarcinoma ◽  
Function Evaluation ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma

Abstract Background Papillary thyroid microcarcinoma (PTMC) has become a main cause of the extremely high incidence of thyroid carcinoma. This study aimed to evaluate the longer-term effectiveness of ultrasound (US)-guided microwave ablation (MWA) for treatment of low-risk PTMC with a large population. Methods This prospective study was approved by ethics committee of our institution. MWA was performed under US-guidance for 119 unifocal PTMC patients without clinically cervical or distant metastasis. The target ablation zone exceeded the tumor edge judged by contrast-enhanced US to avoid marginal residue and recurrence. US and thyroid function evaluation were followed at 1, 3, 6, and 12 months after treatment and every 6 to 12 months thereafter. Any adverse event associated with MWA was evaluated. Results The follow-up duration after MWA was 37.2 ± 20.9 months (range 12-101 months). Tumor volume decreased significantly from 1.87 ± 1.03 mL immediately after MWA to 0.01 ± 0.04 mL at the final evaluation (P < 0.001), with a mean volume reduction ratio of 99.4 ± 2.2% and 107 cases (93.9%) got complete remission. A patient was detected with cervical lymph node metastasis at 26-month follow-up and underwent 1 additional MWA treatment successfully. No distant metastasis was observed. All the acquired histological pathology results confirmed the absence of residual or recurrent tumor cells after MWA. No delayed complications associated with MWA were encountered for all patients. Conclusions Percutaneous MWA is technically feasible for complete PTMC destruction and showed well longer-term effectiveness; thus, it seems to be an effective nonsurgical therapy to complement the current recommendation for selected low-risk PTMC patients.

scholarly journals Long-Term Ultrasound Follow-Up of Thyroid Colloid Cysts

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Dong Wook Kim
Keyword(s):  
Gradual Increase ◽  
Acute Onset ◽  
Papillary Thyroid ◽  
Abrupt Increase ◽  
Interval Change ◽  
Thyroid Microcarcinoma ◽  
Colloid Cysts ◽  
Thyroid Colloid

Objective. This study aimed to assess the interval changes of thyroid colloid cysts (TCCs) by performing long-term ultrasound (US) follow-up examinations.Methods. From 2007 to 2008, 437 patients underwent a lobectomy for the treatment of papillary thyroid microcarcinoma. Among them, 268 patients underwent 4 or more postoperative US follow-ups after surgery. This study investigated the prevalence and interval changes of TCCs≥3 mm by using US follow-ups.Results. Among 268 patients, 35 (13.1%) had TCCs≥3 mm by a preoperative thyroid US, and 6 (2.2%) had newly detected TCCs at a US follow-up. Through long-term US follow-up, the interval changes for TCCs were classified as follows: no interval change (n=8), gradual increase (n=8), gradual decrease (n=5), positive fluctuation (n=3), negative fluctuation (n=6), disappearance (n=5), and new detection (n=6). None of the TCC cases had a TCC that was ≥10 mm at its largest diameter, and no patient complained of any relevant symptoms pertaining to the TCCs.Conclusions. In this study, TCCs demonstrated various interval changes, but no abrupt increase was found or acute onset of symptoms occurred.

scholarly journals Papillary thyroid microcarcinoma: distinct form or cancer growth stage?

2021 ◽  
Vol 14 (4) ◽  
pp. 19-25
Author(s):  
Vladimir A. Solodkiy ◽  
Dmitri K. Fomin ◽  
Dmitri A. Galushko ◽  
Hayk G. Asmaryan
Keyword(s):  
Univariate Analysis ◽  
Central Zone ◽  
Distant Metastases ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
The Past ◽  
Thyroid Microcarcinoma ◽  
Metastatic Lesions ◽  
Thyroid Capsule

Background. Over the past decades an increase in the incidence of papillary thyroid microcarcinoma (PTMC) has been observed throughout the world owing to the improved diagnostics. There are many different opinions about the aggressiveness degree of this group of tumors, as well as about the tactics of managing patients with PTMC.Aim of the study is the identification of the prognostic factors responsible for the features of the clinical course, including the more aggressive one.Materials and methods. A study was carried out with a detailed analysis of a group of patients with papillary thyroid cancer ≤1 cm in size and the existing clinical data of regional and distant metastases. All patients underwent thyroidectomy with bilateral central cervical lymph node dissection. Factors such as gender, patient age, bilaterality, extrathyroid extension, the presence or absence of a capsule around the tumor node, the absence or presence of metastases in the central part were assessed. In 26.6% histological examination revealed metastatic lesions of the central group lymph nodes. Latent metastases were detected in 24.2% of women and 43% of men, in 36.7% of patients <55 and in 14.3% of patients ≥ 55 years, in 29.5% with the absence of the node capsule and in 19.3% with encapsulated tumors, in 48.1% with multicentric growth and in 19.5% with a solitary neoplasm, in 21.7% with a tumor size ≤0.5 cm and in 27.9% with a node of 0.6–1 cm, in 24% with the absence of invasion of the thyroid capsule and in 31% with the presence of extrathyroid invasion, in 21% of patients with typical, in 26% with follicular and 43% with mixed papillary cancer. 95 patients received radioiodine therapy. No additional metastases were found in them.Results. When conducting univariate analysis, the main signs influencing the development of metastases in the central zone were age up to 55 years (p = 0.009, χ2 = 6.919) and multicentric neoplasm (p = 0.004, χ2 = 8.530); in multivariate analysis, similarly, age younger 55 years (p = 0.000, Exp B = 0.011, CI 95.0% 0.001–0.106) and multifocality (p = 0.027, Exp B = 2.686, CI 95.0% 1.119–6.448).Conclusion. PTMC is not a separate group or tumor morphotype, and the determination of treatment tactics for this group of patients should be based not only on the size of the tumor, but on the clinical and biological parameters of the tumor.

scholarly journals Long-Term Efficacy of Ultrasound-Guided Percutaneous Laser Ablation for Low-Risk Papillary Thyroid Microcarcinoma: A 5-Year Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kai Peng ◽  
Ping Zhou ◽  
Wengang Liu
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Low Risk ◽  
Papillary Thyroid ◽  
Ultrasound Guided ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma ◽  
Percutaneous Laser Ablation

Objective. To evaluate the long-term efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for the treatment of low-risk papillary thyroid microcarcinoma (PTMC). Methods. From June 2012 to May 2015, 105 patients with solitary, pathologically confirmed PTMC lesions were treated with ultrasound-guided PLA. Nodule location, nodule volume, thyroid function, and clinical symptoms were evaluated before ablation. Contrast-enhanced ultrasound (CEUS) was performed 1 h after treatment to evaluate whether the ablation was complete. Ultrasound examination was performed at 1, 3, 6, and 12 months after ablation and every 6 months thereafter to determine the size of the ablation area and search for recurrence in the thyroid parenchyma and lymph node metastasis. Thyroid function was examined before and 1 month after ablation. Fine needle aspiration biopsy was performed for any suspicious metastatic lymph nodes and recurrent lesions in the thyroid. Results. All 105 lesions were completely inactivated after one ablation, making the success rate for single ablation 100%. The average ablation time was 2.78 ± 1.05  min, and the average ablation energy was 505 ± 185  J. All patients could tolerate and complete the ablation. No serious complications occurred during the treatment; only minor side effects such as pain and local discomfort were reported. The volume reduction rates were − 781.14 ± 653.29 % at 1 h posttreatment and − 268.65 ± 179.57 % , − 98.39 ± 76.58 % , 36.78 ± 30.32 % , 75.55 ± 21.81 % , 96.79 ± 10.57 % , and 100% at 1, 3, 6, 12, 18, and 24 months after ablation, respectively. This rate remained 100% at the later follow-up times. Overall, 28 (26.67%), 74 (70.48%), 96 (91.43%), and 103 (100%) were completely absorbed by 6, 12, 18, and 24 months after PLA. One patient developed another lesion 12 months after ablation, and two patients had central cervical lymph node metastasis 24 months after ablation. Conclusion. PLA is a safe and effective alternative clinical treatment for low-risk PTMC.

scholarly journals Long-term Outcomes and Prognostic Factors in Papillary Thyroid Microcarcinoma Patients with Distant Metastases

2021 ◽  
Author(s):  
Huai-Yu Weng ◽  
Ting Yan ◽  
Wang-Wang Qiu ◽  
Chuang Xi ◽  
Li-Ying Hou ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Radioactive Iodine ◽  
Distant Metastases ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Long Term Outcomes ◽  
Thyroid Microcarcinoma ◽  
Male Sex

Abstract PurposesDistant metastasis from papillary thyroid microcarcinoma (PTMC) is extremely rare and the long-term outcome and independent prognostic factors remain unclear.The present study aimed to investigate clinicopathological characteristics and evaluate the long-term outcomes and prognostic factors of PTMC patients with distant metastases (DM) who underwent surgery and radioactive iodine (131I) treatment.MethodsWe retrospectively reviewed the medical records of 13,441 patients with thyroid cancer (including 1,697 cases with PTMC) who underwent 131I treatment at our institution between January 2008 and December 2019. PTMC patients with distant metastases with sufficient clinical follow-up data were enrolled in this cohort study. The overall survival (OS) and progression-free survival (PFS) were analyzed by the Kaplan–Meier method and the prognostic factors were assessed by Cox proportional hazards. ResultsThirty-three PTMC patients with DM were enrolled in this study. The median follow-up was 75 months (range: 5–151 months).The 5-year and 10-year OS rates were 96.97% and 81.41%, respectively, and the 5-year and 10-year PFS rates were 90.46% and 69.68%, respectively. Multivariate analysis showed that male sex(P=0.005) , radioactive iodine refractory PTMC (P=0.033) and symptomatic DM (P=0.022) were significantly associated with worse 10-year PFS in PTMC patients with DM. No independent predictor related to poor 10-year OS found in the present study.ConclusionsThe prognosis of PTMC patients becomes worse after the development of DM. Male sex, radioactive iodine refractory PTMC and symptomatic DM were identified as independent factors associated with PFS.

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