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Aggressive papillary thyroid microcarcinoma
European Archives of Oto-Rhino-Laryngology, 03/26/09

Page C et al. - In a study to highlight the fact that papillary thyroid microcarcinoma can be aggressive, requiring therapeutic management similar to that of other differentiated thyroid cancers, it was shown that aggressive papillary thyroid microcarcinoma is not rare and may justify aggressive treatment depending on the presence or absence of prognostic risk factors.

• This 8-yr study concerned 187 surgical pts managed in an ENT and head and neck surgery department for thyroid cancer.
• 65 pts had papillary microcarcinoma.
• 41 microcarcinomas were considered to be aggressive because of presence of risk factors such as larger than 5 mm, multifocal microcarcinomas, capsular effraction, vascular embolus, tumour extension beyond the thyroid parenchyma and metastatic lymphadenopathy.
• All pts with aggressive papillary microcarcinoma were treated by total thyroidectomy and 131I.
• Ipsilateral recurrent laryngeal and lateral cervical lymph node dissections were performed in 10 pts, ipsilateral cervical lymph node dissection was performed in 6 pts, and bilateral recurrent laryngeal and lateral cervical lymph node dissections were performed in 3 pts.

• No recurrence or metastasis was observed (follow-up ranging from 6 mos to 8 yrs).
• Optimal management of thyroid papillary microcarcinoma is still controversial.

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