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Management of incidental and non-incidental papillary thyroid microcarcinoma

Published online by Cambridge University Press:  02 April 2013

M S Elliott ,
K Gao ,
R Gupta ,
E L Chua ,
A Gargya  and
J Clark
M S Elliott*
Affiliation:
Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia Sydney Medical School, University of Sydney, New South Wales, Australia
K Gao
Affiliation:
Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia
R Gupta
Affiliation:
Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
E L Chua
Affiliation:
Sydney Medical School, University of Sydney, New South Wales, Australia Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia
A Gargya
Affiliation:
Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia
J Clark
Affiliation:
Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia
*
Address for correspondence: Dr Michael Elliott, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW, Australia 2050 E-mail: [email protected]
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Abstract

Background:

The incidence of papillary thyroid cancer is rising, with an increase in the number of microcarcinomas being discovered. There is controversy in the literature regarding the optimal management of these tumours. This study aimed to review our institution's experience with the presentation and management of papillary thyroid microcarcinoma.

Methods:

Retrospective analysis from the Sydney Head and Neck Cancer Institute, from 1987 to 2009.

Results:

A total of 228 patients were analysed. Papillary thyroid microcarcinomas were discovered incidentally in 116 (50.9 per cent) patients and non-incidentally in the remaining 112 (49.1 per cent) patients. Amongst the non-incidental group, 11.6 per cent of patients presented with lateral cervical lymph node involvement. Non-incidental microcarcinomas were significantly associated with younger age (<45 years) (p = 0.007) and larger tumours (5–10 mm) (p < 0.001). Only four patients in the incidental group suffered recurrent disease (locoregional). No patient developed distant metastatic disease or died during follow up.

Conclusion:

Papillary thyroid microcarcinomas present both incidentally and non-incidentally, with equal prevalence. Non-incidental tumours not infrequently present with cervical lymph node disease. The patient outcome is generally excellent.

Keywords

Papillary Thyroid MicrocarcinomaThyroid CancerThyroid Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S2 , July 2013 , pp. S17 - S23
Copyright
Copyright © JLO (1984) Limited 2013 

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