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

2014 ◽  
Vol 128 (10) ◽  
pp. 922-925 ◽  
Author(s):  
R Varshney ◽  
M N Pakdaman ◽  
N Sands ◽  
M P Hier ◽  
L Rochon ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Central Compartment ◽  
Extrathyroidal Extension ◽  
Papillary Microcarcinoma ◽  
Extrathyroidal Invasion ◽  
Thyroid Papillary ◽  
Node Metastases ◽  
Tumour Characteristics ◽  
Papillary Microcarcinomas

AbstractObjective: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.

scholarly journals Immediate Surgery Might Be a Better Option for Subcapsular Thyroid Microcarcinomas

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jun Jiang ◽  
Hui Lu
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Node Metastases ◽  
Tumour Size ◽  
Central Compartment ◽  
Extrathyroidal Extension ◽  
Lateral Lymph Node ◽  
Initial Surgery ◽  
Node Metastases ◽  
Immediate Surgery

For high-risk papillary thyroid microcarcinomas (PTMCs), immediate surgery is recommended. This study aimed to evaluate the location of PTMCs in the thyroid lobe and determine whether location is associated with an aggressive biology and the necessity of immediate surgery. This retrospective study included 288 patients who underwent initial surgery for PTMC. Clinical data were extracted. Subcapsular thyroid microcarcinomas (STMs) and nonsubcapsular thyroid microcarcinomas (NSTMs), distinguished by ultrasound, were compared in terms of tumour size, extrathyroidal extension, cervical lymph node metastasis, and multifocality. The preoperative ultrasound features predictive of recurrent laryngeal nerve (RLN) involvement were assessed. There were no statistical differences in tumour size (P = 0.985), multifocality (P = 0.866), lymph node metastases to the central compartment (P = 0.154), or lateral lymph node metastases (P = 0.929) between STM and NSTM groups. Macroscopic extrathyroidal extension was exclusively found in the STM group. For assessing RLN involvement, the sensitivity, specificity, and positive predictive value of the presence of an abnormal thyroid capsule margin between the STM and the presumed RLN course, assessed on preoperative ultrasonography images, were 100%, 43.3%, and 43.3%, respectively. Immediate surgery appears to be a better option than conservative treatment for these high-risk STM patients.

scholarly journals Papillary Thyroid Carcinoma Arising in Children and Adolescent Hashimoto’s Thyroiditis: Ultrasonographic and Pathologic Findings

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sun Hye Jeong ◽  
Hyun Sook Hong ◽  
Eun Hye Lee ◽  
Jeong Ja Kwak
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Hashimoto’S Thyroiditis ◽  
Extrathyroidal Extension ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Node Metastases

Objectives. We compared the ultrasonography and pathology features of papillary thyroid carcinoma (PTC) in pediatric and adolescents with Hashimoto’s thyroiditis (HT) with those of non-HT patients.Materials and Methods. Eleven patients who were surgically confirmed to have pediatric or adolescent PTC from 2006 to 2014 were included in this study. We retrospectively analyzed the preoperative ultrasonography and pathology features of PTC arising in HT and non-HT patients.Results. On ultrasonography, thyroid gland was lobulated and enlarged, with many scattered microcalcifications in four of five HT patients. Four of six non-HT patients had suspicious masses with calcifications. The diffuse sclerosing variant of PTC (DSVPTC) was found in three of five HT patients, but none in non-HT patients. Macroscopic or microscopic extrathyroidal extension was evident in all of the HT patients and four of the non-HT patients. Neck lymph node metastases were in all HT patients and five of non-HT patients.Conclusions. Three of five PTCs in pediatric and adolescent HT patients were DSVPTC, whereas all PTCs of the non-HT patients were classic type. On ultrasonography, thyroid gland was diffusely enlarged with scattered microcalcifications in four of five HT patients. All five HT cases had aggressive disease, including extrathyroidal extension and cervical lymph node metastases.

scholarly journals Analysis of risk factors for cervical lymph node metastases in patients with sporadic medullary thyroid carcinoma

2018 ◽  
Vol 46 (5) ◽  
pp. 1982-1989 ◽  
Author(s):  
Weina Fan ◽  
Cheng Xiao ◽  
Fusheng Wu
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Central Compartment ◽  
Antigen Concentration ◽  
Cervical Lymph Node Metastases ◽  
Serum Carcinoembryonic Antigen ◽  
Node Metastases ◽  
Thyroid Capsule ◽  
Capsule Invasion

Objective Medullary thyroid carcinoma (MTC) is classified as either sporadic or inherited. This study was performed to analyze the risk factors for cervical lymph node metastases and predict the indication for prophylactic lateral neck dissection in patients with sporadic MTC. Methods Sixty-five patients with sporadic MTC were retrospectively reviewed. Univariate analysis with the chi-square test and multiple logistic regression analysis were applied to identify the clinicopathological features (sex, age, tumor size, number of tumor foci, capsule or vascular invasion, and others) associated with cervical lymph node metastases. Results The metastasis rates in the central and lateral compartments were 46.2% (30/65) and 40.0% (26/65), respectively. The incidence of cervical lymph node metastases was significantly higher in patients with a tumor size of >1 cm, tumor multifocality, and thyroid capsule invasion. Only thyroid capsule invasion was an independent predictive factor for central compartment metastases and lateral neck metastases. The possibility of central compartment metastases was significantly higher when the preoperative serum carcinoembryonic antigen concentration was >30 ng/mL (60.0% vs. 34.3%). Conclusions MTC is associated with a high incidence of cervical lymph node metastases. Prophylactic lateral node dissection is necessary in patients with thyroid capsule invasion or a high serum carcinoembryonic antigen concentration.

Selective use of radioactive iodine therapy for papillary thyroid cancers with low or lower-intermediate recurrence risk

2020 ◽  
Author(s):  
Giorgio Grani ◽  
Livia Lamartina ◽  
Marco AlfÒ ◽  
Valeria Ramundo ◽  
Rosa Falcone ◽  
...  
Keyword(s):  
Lymph Node ◽  
Soft Tissues ◽  
Distant Metastases ◽  
Central Compartment ◽  
Recurrence Risk ◽  
Lymph Node Status ◽  
Papillary Thyroid ◽  
Extrathyroidal Invasion ◽  
Node Metastases

Abstract Context Current guidelines recommend a selective use of radioiodine treatment (RAI) for papillary thyroid cancer (PTC). Objective To determine how policy changes affect the use of RAI and the short-term outcomes of patients. Design Retrospective analysis of longitudinal data. Setting Academic referral center. Patients Patients with non-aggressive PTC variants; no extrathyroidal invasion or limited to soft tissues, no distant metastases, and ≤5 central-compartment cervical lymph node metastases. In Cohort 1, standard treatments were total thyroidectomy and RAI (May 2005-June 2011); in Cohort 2 decisions on RAI were deferred for ~12 months after surgery (July 2011-December 2018). Propensity score matching was used to adjust for sex, age, tumor size, lymph node status, and extrathyroidal extension. Intervention Immediate RAI or deferred choice. Main outcome measures Responses to initial treatment in ≥3 years of follow-up. Results In Cohort 1, RAI was performed in 50/116 patients (51.7%), while in Cohort 2, it was far less frequent: immediately in 10/156 (6.4%), and in 3 more patients after the first follow-up data. The frequencies of structural incomplete response were low (1-3%), and there were no differences between the two cohorts at any follow-up visit. Cohort 2 patients had higher rates of “gray-zone responses” (biochemical incomplete or indeterminate response). Conclusions Selective use of RAI increases the rate of patients with “uncertain” status during early follow-up. The rate of structural incomplete responses remains low regardless of whether RAI is used immediately or not. Patients should be made aware of both the advantages and drawbacks of omitting RAI.

scholarly journals A Preoperative Nomogram for the Prediction of Ipsilateral Central Compartment Lymph Node Metastases in Papillary Thyroid Cancer

Thyroid ◽  
2014 ◽  
Vol 24 (4) ◽  
pp. 675-682 ◽  
Author(s):  
Andrew M. Thompson ◽  
Robin M. Turner ◽  
Andrew Hayen ◽  
Ahmad Aniss ◽  
Salvatore Jalaty ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Central Compartment ◽  
Papillary Thyroid ◽  
Node Metastases

scholarly journals Prevalence of Central Compartment Lymph Node Metastases in Papillary Thyroid Micro-Carcinoma: A Retrospective Evaluation of Predictive Preoperative Features

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6028
Author(s):  
Marta Tagliabue ◽  
Gioacchino Giugliano ◽  
Maria Cecilia Mariani ◽  
Manila Rubino ◽  
Enrica Grosso ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Binary Logistic Regression ◽  
Central Compartment ◽  
Good Prognosis ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
Node Metastases ◽  
Central Lymph

Papillary thyroid micro-carcinomas are considered relatively indolent carcinomas, often occult and incidental, with good prognosis and favorable outcomes. Despite these findings, central lymph node metastases are common, and are related to a poor prognosis for the patient. We performed a retrospective analysis on patients treated with surgery for stage pT1a papillary thyroid micro-carcinomas. One hundred ninety-five patients were included in the analyses. The presence of central lymph node metastases was identified and studied. A multivariate analysis employing binary logistic regression was used to calculate adjusted odds ratios with 95% confidence intervals of possible central lymph node metastases risk factors. In the performed multivariate analysis, male gender, younger age, and histopathological characteristics, such as a tumor sub-capsular localization, were significantly associated with central lymph node metastases in pT1a patients. Central compartment lymph node metastases are present in a non-negligible number of cases in patients with papillary thyroid micro-carcinoma undergoing surgical resection. Studying these factors could be an effective tool for predicting patients’ central lymph node metastases in papillary thyroid micro-carcinomas, defining a tailored surgical treatment in the future.

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