Tumor size measured by preoperative ultrasonography and postoperative pathologic examination in papillary thyroid carcinoma: relative differences according to size, calcification and coexisting thyroiditis

2013 ◽  
Vol 271 (5) ◽  
pp. 1235-1239 ◽  
Author(s):  
Young Hoon Yoon ◽  
Ki Ryun Kwon ◽  
Seo Young Kwak ◽  
Kyeung A. Ryu ◽  
Bobae Choi ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Papillary Thyroid ◽  
Pathologic Examination ◽  
Preoperative Ultrasonography ◽  
Relative Differences

scholarly journals Association between Tumor Size and Bilateral Involvement in Papillary Thyroid Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Suna Erkilic ◽  
Fatih Celenk ◽  
Zehra Bozdag
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Surgical Procedure ◽  
Tertiary Care ◽  
Papillary Thyroid ◽  
Tertiary Care Medical Center ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. Tumor multifocality and bilaterality of papillary thyroid carcinoma (PTC) are important factors when selecting the most appropriate surgical procedure. The aim of this study was to assess the bilaterality rate in PTC and the relationship between the tumor size and bilaterality.Materials and Methods. Thyroidectomy specimens with a diagnosis of PTC were retrospectively reviewed in the Pathology Department of a tertiary care medical center. Specimens were divided into three groups according to the size of the primary and contralateral tumor foci. Tumors less than or equal to 1 cm in each lobe were included in group 1. Group 2 consisted of tumors greater than 1 cm in one lobe and less than 1 cm in the other lobe. Tumors greater than 1 cm in each lobe were included in group 3.Results. We identified 868 total thyroidectomy specimens with a diagnosis of PTC between 2001 and 2011. Of these cases, both thyroid lobes were involved in 262 cases (32%). There were 109 (42%), 121 (46%), and 32 cases (12%) in group 1, group 2, and group 3, respectively.Conclusion. Bilaterality is frequent in PTC and is not related to tumor size. Accordingly, the high frequency of bilateral disease in PTC should be kept in mind when determining the extent of the surgical procedure.

scholarly journals Is BRAFV600E mutation a marker for central nodal metastasis in small papillary thyroid carcinoma?

2014 ◽  
Vol 21 (2) ◽  
pp. 285-295 ◽  
Author(s):  
Brian Hung-Hin Lang ◽  
Young Jun Chai ◽  
Benjamin J Cowling ◽  
Hye Sook Min ◽  
Kyu Eun Lee ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Protective Factor ◽  
Independent Predictor ◽  
Nodal Metastasis ◽  
Prediction Score ◽  
Papillary Thyroid ◽  
Male Sex ◽  
Central Nodal Metastasis

Utilizing BRAFV600E mutation as a marker may reduce unnecessary prophylactic central neck dissection (pCND) in clinically nodal negative (cN0) neck for small (≤2 cm) classical papillary thyroid carcinoma (PTC). We aimed to assess whether BRAF is a significant independent predictor of occult central nodal metastasis (CNM) and its contribution to the overall prediction after adjusting for other significant preoperative clinical factors in small PTC. Primary tumor tissue (paraffin-embedded) from 845 patients with small classical cN0 PTC who underwent pCND was tested for BRAF mutation. Clinicopathologic factors were compared between those with and without BRAF. BRAF was evaluated to see if it was an independent factor for CNM. Prediction scores were generated using logistic regression models and their predictability was measured by the area under the ROC curve (AUC). The prevalence of BRAF was 628/845 (74.3%) while the rate of CNM was 285/845 (33.7%). Male sex (odds ratio (OR): 2.68, 95% CI: 1.71–4.20), large tumor size (OR: 2.68, 95% CI: 1.80–4.00), multifocality (OR: 1.49, 95% CI: 1.07–2.09), lymphovascular permeation (OR: 10.40, 95% CI: 5.18–20.88), and BRAF (OR: 1.65, 95% CI: 1.10–2.46) were significant independent predictors of CNM, while coexisting Hashimoto's thyroiditis (OR: 0.56, 95% CI: 0.40–0.80) was an independent protective factor. The AUC for prediction score based on tumor size and male sex was similar to that of prediction score based on tumor size, male sex, and BRAF status (0.68 vs 0.69, P=0.60). Although BRAF was an independent predictor of CNM, knowing its status did not substantially improve the overall prediction. A simpler prediction score based on male sex and tumor size might be sufficient.

scholarly journals Occult Papillary Thyroid Carcinoma without Detection of the Primary Tumor on Preoperative Ultrasonography or Postoperative Pathological Examination: A Case Report

2020 ◽  
Vol 13 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Gai Yamashita ◽  
Takahito Kondo ◽  
Akira Okimura ◽  
Munehide Nakatsugawa ◽  
Hiroshi Hirano ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Primary Tumor ◽  
Thyroid Tissue ◽  
Pathological Examination ◽  
Papillary Thyroid ◽  
Superficial Lobe ◽  
Preoperative Ultrasonography ◽  
The Right

Herein, we report a case of an occult thyroid cancer that was not detected as a primary tumor on preoperative ultrasonography or postoperative pathological examination, although a diagnosis of papillary thyroid carcinoma metastasis was made owing to the presence of a mass in the right upper neck. Needle biopsy of the mass in the right upper neck revealed positive results for thyroglobulin and TTF-1 on immunostaining, and a papillary thyroid carcinoma was observed with papillary and follicular patterns. We suspected papillary thyroid carcinoma (T0N1bM0) or ectopic papillary thyroid carcinoma. Accordingly, we performed total thyroidectomy, central lymph node dissection, right lateral neck dissection, and resection of the superficial lobe of the right parotid. A postoperative pathological examination of 5-mm slices of the specimen revealed no primary tumor in the thyroid. However, a hyalinized image of the thyroid indicated that a micropapillary thyroid carcinoma might have spontaneously disappeared. As there was no normal thyroid tissue in the metastasis to the superior internal jugular lymph node, the tumor was unlikely to be an ectopic papillary thyroid carcinoma. Therefore, we made a diagnosis of a papillary thyroid carcinoma (pT0N1bM0). After surgery, we determined that the tumor belonged to a high-risk group of papillary thyroid carcinomas and a poor-prognosis group of symptomatic papillary thyroid microcarcinomas; accordingly, ablation was performed with 30 mCi iodine-131. There was no recurrence or metastasis 24 months after the first surgery.

scholarly journals Investigation of the prognosis of patients with papillary thyroid carcinoma by tumor size

2012 ◽  
Vol 59 (6) ◽  
pp. 457-464 ◽  
Author(s):  
Yasuhiro Ito ◽  
Mitsuhiro Fukushima ◽  
Minoru Kihara ◽  
Yuuki Takamura ◽  
Kaoru Kobayashi ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Papillary Thyroid

scholarly journals Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Tumor Size ◽  
Frozen Section ◽  
Extrathyroidal Extension ◽  
Capsular Invasion ◽  
Papillary Thyroid

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.

scholarly journals The Clinical and Prognosis Value of the Number of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma Patients

2020 ◽  
Author(s):  
Ling Zhan ◽  
Hong-fang Feng ◽  
Xi-zi Yu ◽  
Ling-rui Li ◽  
Jun-long Song ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Tumor Diameter ◽  
Papillary Thyroid ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
High Prevalence

Abstract Objective: It has been reported that papillary thyroid carcinoma (PTC) patients with lymph node metastasis (LNM) are more associated with adverse outcomes. This study aimed to assess the correlation between the lymph node (LN) status and clinical prognosis in PTC patients. Methods: We retrospectively reviewed the medical records of PTC patients who underwent initial thyroid cancer surgery in Renmin Hospital of Wuhan University between 2017 and 2019. 1021 PTC patients with total checked number of lymph nodes ≥5 were involved in this study. The clinicopathological characteristics of patients were compared according to the LN status and the number of metastatic lymph nodes (NMLNs). Results: The LNM and NMLNs>5 were seen in 694 (68.0%) and 222 (21.7%) cases, respectively. Young patients, patients with larger tumor diameter, bilaterality, multifocality and gross extrathyroidal extension (ETE) were more inclined to LNM and NMLNs >5 (P<0.001). The patients with LNM (pN1) were mainly among males and were exhibited multifocality and advanced tumor stage (P<0.001), while pN1 patients with NMLNs >5 were negatively associated with advanced tumour stage (P<0.05). Recurrence-free survival among pN1 patients was significantly different between 2 groups (NMLNs ≤5: 0/472, 100.0%; NMLNs >5: 5/222, 97.7%; P=0.002). In multivariate logistic regression analysis, the male (OR=2.580, P<0.001), 10-mm tumor size (OR=1.770, P<0.001), tumor gross ETE (OR=2.004, P<0.001) were independent predictors for the high prevalence of LNM. Similarly, 10-mm tumor size (OR=1.399, P<0.05), bilaterality (OR=2.350, P<0.001) and tumor gross ETE (OR=2.660, P<0.05) were also independent predictors for the high prevalence of NMLNs >5; 10-year age was an independent predictor for the low prevalence of the LNM (OR=0.658, P<0.001) and NMLNs >5 (OR=0.678, P<0.001). Conclusions: The status of the cervical LNs and the NMLNs should be correctly evaluated to guide reasonable treatment and careful follow-up.

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