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Lymph node metastasis in thyroid papillary microcarcinoma: a study of 170 patients

Published online by Cambridge University Press:  16 September 2014

R Varshney ,
M N Pakdaman ,
N Sands ,
M P Hier ,
L Rochon ,
M J Black  and
R J Payne
R Varshney*
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
M N Pakdaman
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
N Sands
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
M P Hier
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
L Rochon
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
M J Black
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
R J Payne
Affiliation:
McGill University, Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
*
Address for correspondence: Dr R Varshney, McGill University, 59 Papillon, Dollard-des-Ormeaux, QC, CanadaH9B3M3 Fax: 001 514 421–5518 E-mail: [email protected]
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Abstract

Objective:

Papillary microcarcinoma of the thyroid has been described as either a normal variant or a serious malignancy. We describe our experience with papillary microcarcinoma and lymph node metastases.

Method:

A total of 685 consecutive total thyroidectomies with central compartment neck dissection were reviewed for papillary microcarcinoma. Association of central compartment lymph node metastases with age, gender, tumour multifocality, bilaterality and extrathyroidal extension was analysed.

Results:

Out of 170 papillary microcarcinoma cases, multifocality was found in 72 (42.4 per cent), bilaterality in 49 (28.8 per cent) and extrathyroidal extension in 16 (9.4 per cent). In all, 23 patients (13.5 per cent) had lymph node metastases. There was a significant association (p < 0.05) between extrathyroidal extension (but no other tumour characteristics) and lymph node metastases.

Conclusion:

In all, 13.5 per cent of papillary microcarcinomas in our series showed lymph node metastases. Lymph node metastases were associated with extrathyroidal invasion of the papillary microcarcinoma.

Keywords

Thyroid GlandPapillary Thyroid MicrocarcinomaThyroid NeoplasmsThyroid NoduleLymph NodesNeoplasm MetastasisNeoplasm Invasiveness
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 10 , October 2014 , pp. 922 - 925
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Hedinger, C, Williams, ED, Sobin, LH. The WHO histological classification of thyroid tumors: a commentary on the second edition. Cancer 1989;63:908–11Google Scholar
2Ito, Y, Miyauchi, A. A therapeutic strategy for incidentally detected papillary microcarcinoma of the thyroid. Nat Clin Pract Endocrinol Metab 2007;3:240–8CrossRefGoogle ScholarPubMed
3Pazaitou-Panayiotou, K, Capezzone, M, Pacini, F. Clinical features and therapeutic implication of papillary thyroid microcarcinoma. Thyroid 2007;17:1085–92Google Scholar
4McDougall, R, Camargo, CA. Treatment of micropapillary carcinoma of the thyroid: where do we draw the line? Thyroid 2007;17:1093–5Google Scholar
5Pelizzo, MR, Boschin, IM, Toniato, A, Piotto, A, Bernante, P, Pagetta, C et al. Papillary thyroid microcarcinoma (PTMC): Prognostic factors, management and outcome in 403 patients. Eur J Surg Oncol 2006;32:1144–8CrossRefGoogle ScholarPubMed
6Chow, SM, Law, SCK, Chan, JKC, Au, SK, Yau, S, Lau, WH. Papillary microcarcinoma of the thyroid—prognostic significance of lymph node metastasis and multifocality. Cancer 2003;98:31–40CrossRefGoogle ScholarPubMed
7Roti, E, Rossi, R, Trasforini, G, Bertelli, F, Ambrosio, MR, Busutti, L et al. Clinical and histological characteristics of papillary thyroid microcarcinoma: results of a retrospective study in 243 patients. J Clin Endocrinol Metab 2006;91:2171–8CrossRefGoogle ScholarPubMed
8Baudin, E, Travagli, JP, Ropers, J, Mancusi, F, Bruno-Bossio, G, Caillou, B et al. Microcarcinoma of the thyroid gland: the Gustave-Roussy Institute experience. Cancer 1998;83:553–9Google Scholar
9Fend, F, Gruber, U, Fritzsche, H, Rothmund, J, Breitfellner, G, Mikuz, G. Occult papillary carcinoma of the thyroid with pulmonary lymphangitic spread diagnosed by lung biopsy. Klin Wochenschr 1989;67:687–90CrossRefGoogle ScholarPubMed
10Michie, HR, O'Bryan-Tear, CG, Marsh, H, Glazer, G. Cerebral metastases from occult papillary carcinoma of the thyroid. Br J Surg 1987;74:647Google Scholar
11Lin, KD, Lin, JD, Huang, MJ, Huang, HS, Jeng, LB, Chao, TC et al. Clinical presentations and predictive variables of thyroid microcarcinoma with distant metastasis. Int Surg 1997;82:378–81Google ScholarPubMed
12Lin, JD, Chen, ST, Chao, TZ, Hsueh, C, Weng, HF. Diagnosis and therapeutic strategy for papillary thyroid microcarcinoma. Arch Surg 2005;140:940–5Google Scholar
13Wada, N, Duh, QY, Sugino, K, Iwasaki, H, Kameyama, K, Mimura, T et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg 2003;237:399–407Google Scholar
14Sampson, RJ, Oka, H, Key, CR, Buncher, CR, Iijima, S. Metastases from occult thyroid carcinoma. An autopsy study from Hiroshima and Nagasaki, Japan. Cancer 1970;25:803–11Google Scholar
15Gülben, K, Berberoğlu, U, Çelen, O, Mersin, HH. Incidental papillary microcarcinoma of the thyroid-factors affecting lymph node metastasis. Langenbecks Arch Surg 2008;393:25–9CrossRefGoogle ScholarPubMed
16Kasai, N, Sakamoto, A. New subgrouping of small thyroid carcinomas. Cancer 1987;60:1767–70Google Scholar
17Pellegriti, G, Scollo, C, Lumera, G, Regalbuto, C, Vigneri, R, Belfiore, A. Clinical behavior and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: study of 299 cases. J Clin Endocrinol Metab 2004;89:3713–20CrossRefGoogle ScholarPubMed
18Davies, L, Welch, HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295:2164–7Google Scholar
19Pakdaman, MN, Rochon, L, Gologan, O, Tamilia, M, Garfield, N, Hier, MP et al. Incidence and histopathological behavior of papillary microcarcinomas: study of 429 cases. Otolaryngol Head Neck Surg 2008;139:718–22CrossRefGoogle ScholarPubMed
20Burman, KD. Micropapillary thyroid cancer: should we aspirate all nodules regardless of size? J Clin Endocrinol Metab 2006;91:2043–6Google Scholar
21Orsenigo, E, Beretta, E, Fiacco, E. Management of papillary microcarcinoma of the thyroid gland. Eur J Surg Oncol 2004;30:1104–6Google Scholar
22Ito, Y, Uruno, T, Nakano, K, Takamura, Y, Miya, A, Kobayashi, K et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid 2003;13:381–7CrossRefGoogle ScholarPubMed