Incidental and non-incidental papillary thyroid microcarcinomas: Case series from the endocrinology clinic and institute of pathology targu mure?

摘要

Objective. To study papillary thyroid microcarcinomas (PTMCs) detected incidentallyon-incidentally, especially those with suggestive signs for progression into clinically overt forms. Material and methods. In the first part of study 102 microcarcinomas diagnosed between 1988-2008 were investigated. In the second part we included all the 311 patients thyroidectomized for different thyroid diseases in surgical clinics from Targu Mures in 2007. Results. During 1988-2008 the frequency of PTMCs increased progressively, achieving a peak in 2007 (46.5% of 58 PTCs). In 2007 from the 311 thyroidectomies 27 microcarcinomas were diagnosed, the majority (70.3%) being incidentalomas. In incidental and non-incidental PTMC groups the rate of microcarcinomas with potential progression into overt carcinomas was 21% and 50%, respectively. Only non-incidental forms with signs of progression were treated by total thyroidectomy in every case, while microincidentalomas just in about half of cases, although all must be treated the same way. Conclusions. After the Chernobyl nuclear accident and use of modern diagnostic methods (ultrasound and FNA) the frequency of PTCs has increased progressively and significantly, including that of microcarcinomas diagnosed mostly incidentally. We must pay attention for PTMCs, because in our casuistry 29.6% harbored suggestive signs (multifocality, extrathyroidal extension, regional lymph node metastases) for progression.