Papillary thyroid microcarcinoma: impossible to operate observe – where to put a comma?

Abstract

Objective. To evaluate the efficiency of diagnostics and treatment in patients with microcarcinomas of the thyroid gland at the State Medical Institution "RCOD of the Ministry of Health of the Republic of Tatarstan named after Professor. M.Z. Sigal" for 2020-22.

Materials and methods. MIS "BARS. Healthcare – MIS" of oncological dispensary, outpatient charts and medical histories of patients operated on for thyroid microcarcinomas were used.

Results. In the study group, all patients had papillary microcarcinoma. Women over 45 years of age prevailed. Women of fertile age accounted for 41.7%. The combination of microcarcinoma with thyroid adenomas, colloidal goiter and AIT was detected in 78.6% of patients. The organ capsule invasion occurred in 35.7% of patients, metastases to regional lymph nodes – in 19%. Thyroidectomy was performed in 66.7% of patients; 12 (28.6%) patients underwent I-131 therapy.

Conclusions. Due to the fact that papillary microcarcinoma of the thyroid gland is often found in women of fertile age, and develops against the background of another thyroid pathology complicating diagnostics, it sprouts an organ capsule in 35.7% and gives metastases to regional lymph nodes in 19%, therefore requires a timely diagnostics and radical treatment.

Keywords

papillary microcarcinoma / thyroid gland

References

[1] La Vecchia C., Malvezzi M., Bosetti C., Garavello W., Bertuccio P., Levi F., Negri E. Thyroid cancer mortality and incidence: a global overview. Int J Cancer 2015; 136: 2187–2195. DOI: 10.1002/ijc.29251.

[2] Ahn H.S., Kim H.J., Welch H.G. Korea's thyroid-cancer "epidemic" – screening and overdiagnosis. New Engl J Med 2014; 371 (19): 1765–1767. DOI: 10.1056/NEJMp1409841

[3] Udelsman R., Zhang Y. The epidemic of thyroid cancer in the united states: The role of endocrinologists and ultrasounds. Thyroid 2014; 24 (3): 472–479. DOI: 10.1089/thy.2013.0257.

[4] Wang T. S, Goffredo P., Sosa J.A., Roman S.A. Papillary thyroid microcarcinoma: An over-treated malignancy? World J Surg. 2014; 38 (9): 2297–2303. DOI: 10.1007/s00268-014-2602-3

[5] Wang T.S., Goffredo P., Sosa J.A., Roman S.A. Papillary thyroid microcarcinoma: An over-treated malignancy? World J Surg. 2014; 38 (9): 2297–2303. DOI: 10.1007/s00268-014-2602-3

[6] Page C., Biet A., Boute P., Cuvelier P., Strunski V. ‘Aggressive papillary’ thyroid microcarcinoma. Eur. Arch. Otorhino-laryngol. 2009; 266 (12): 1959–1963. DOI: 10.1007/s00405-009-0952-5

[7] Page C., Biet A., Boute P., Cuvelier P., Strunski V. ‘Aggressive papillary’ thyroid microcarcinoma. Eur. Arch. Otorhinolaryngol. 2009; 266 (12): 1959–1963. DOI: 10.1007/s00405-009-0952-5

[8] Lee Y.S., Lim H., Chang H.S., Park C.S. Pa-pillary thyroid microcarcinomas are different from latent papillary thyroid carcinomas at autopsy. J Korean. Med. Sci. 2014; 29 (5): 676–679. DOI: 10.3346/jkms.2014.29.5.676 50.

[9] Lee Y.S., Lim H., Chang H.S., Park C.S. Pa-pillary thyroid microcarcinomas are dif-ferent from latent papillary thyroid carcinomas at autopsy. J Korean. Med. Sci. 2014; 29 (5): 676–679. DOI: 10.3346/jkms.2014.29.5.676 50.

[10] Lin J.-D. Increased incidence of papillary thyroid microcarcinoma with decreased tumor size of thyroid cancer. Med. Oncol. 2009; 27 (2): 510–518. DOI: 10.1007/s12032-009-9242-8.

[11] Fridman M.V., Nerovnya A.M., Demidchik Yu. E., Gedrevich Z.E., Bragina Z.N. Preoperative diagnosis of microcarcinomas. Minsk 2002; 15 (in Russian).

[12] Фридман М.В., Неровня А.М., Демидчик Ю.Е., Гедревич З.Э., Брагина З.Н. Дооперационная диагностика микрокарцином. Минск 2002; 15.

[13] Hughes D.T., Haymart M.R., Miller B.S., Gauger P.G., Doherty G.M. The most commonly occurring papillary thyroid cancer in the united states is now a microcarcinoma in a patient older than 45 years. Thyroid 2011; 21 (3): 231–236. DOI: 10.1089/thy.2010.0137

[14] Differentiated thyroid cancer: clinical guidelines. Moscow: Ministerstvo zdravookhraneniya RF 2020 (in Russian).

[15] Дифференцированный рак щитовидной железы: клинические рекомендации. М.: Министерство здравоохранения РФ 2020.

[16] Kaliszewski K., Zubkiewicz-Kucharska A., Kiełb P., Maksymowicz J., Krawczyk A., Krawiec O. Comparison of the prevalence of incidental and non-incidental papillary thyroid microcarcinoma during 2008–2016: a single-center experience. World J Surg Oncol. 2018; 16 (1): 202. DOI: 10.1186/s12957-018-1501-8

[17] Ryabchenko E.V. Retrospective compari-son of individual risk factors hemithyroidectomy and thyroidectomy in patients with papillary carcinoma of the thyroid gland in combination with autoimmune thyroiditis. Opukholi golovy i shei 2022; 12 (4): 71–80. DOI: 10.17650/2222-1468-2022-12-4-71-80 (in Russian).

[18] Рябченко Е.В. Ретроспективное сопоставление индивидуальных факторов риска гемитиреоидэктомии и тиреоидэктомии у пациентов с папиллярной микрокарциномой щитовидной железы, возникшей на фоне аутоиммунного тиреоидита. Опухоли головы и шеи 2022; 12 (4): 71–80. DOI: 10.17650/2222-1468-2022-12-4-71-80

[19] Sakorafas G.H., Giotakis J., Stafyla V. Papillary thyroid microcarcinoma: a surgical perspective. Cancer Treat Rev. 2005; 31 (6): 423–38. DOI: 10.1016/j.ctrv.2005.04.009.

[20] Pelizzo M.R., Merante Boschin I., Toniato A., Piotto A., Bernante P., Pagetta C., Casal Ide E., Mazzarotto R., Casara D., Rubello D. Papillary thyroid microcarci-noma. Long-term outcome in 587 cases compared with published data. Minerva Chir. 2007; 62 (5): 315–325.

[21] Pelizzo M.R., Merante Boschin I., Toniato A., Piotto A., Bernante P., Pagetta C., Casal Ide E., Mazzarotto R., Casara D., Rubello D. Papillary thyroid microcarcinoma. Long-term outcome in 587 cases compared with published data. Minerva Chir. 2007; 62 (5): 315–325.

[22] Solodkiy V.A., Fomin D.K., Galushko D.A., Asmaryan A.G. Papillary thyroid microcarcinoma: distinct form or cancer growth stage? Endokrinnaya khirurgiya 2020; 14 (4): 19–25. DOI: 10.14341/serg12696 (in Russian).

[23] Солодкий В.А., Фомин Д.К., Галушко Д.А., Асмарян А.Г. Папиллярная микрокарцинома щитовидной железы: отдельная нозология или одна из стадий развития рака? Эндокринная хирургия 2020; 14 (4): 19–25. DOI: 10.14341/serg12696

RIGHTS & PERMISSIONS

Eco-Vector