scholarly journals The Overdiagnosis of Thyroid Micropapillary Carcinoma: The Rising Incidence, Inert Biological Behavior, and Countermeasures

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shujian Xu ◽  
Yong Han
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Clinical Management ◽  
Low Risk ◽  
Biological Behavior ◽  
Papillary Thyroid ◽  
Micropapillary Carcinoma ◽  
The Past ◽  
Thyroid Microcarcinoma ◽  
Rising Incidence

The incidence of papillary thyroid microcarcinoma (PTMC) has exponentially increased in the past three decades. The 2014 World Cancer Report stated that, among the new cases of thyroid carcinoma, >50% are PTMC. The incidence of thyroid cancer was growing by 20.1% annually in China. Most of PTMC have low risk and excellent prognoses. It must be realized that the problem of overdiagnosis of thyroid cancer is quite serious. In this article, we summarized the phenomenon and the cause of “overdiagnosis” of PTMC, the progress of clinical management, and the countermeasures.

scholarly journals Hemithyroidectomy: Papillary Thyroid Carcinoma in Low Risk Group Patients

2020 ◽  
Vol 5 (6) ◽  
pp. 376-380
Author(s):  
Islam MA ◽  
Mohammed T ◽  
Mamoon TB ◽  
Chowdhury NH ◽  
Khan SR ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Treatment Strategy ◽  
Risk Group ◽  
Low Risk ◽  
Papillary Thyroid ◽  
Histologic Subtype ◽  
Size Threshold ◽  
Single Size

Papillary thyroid cancer (PTC) is the most prevalent histologic subtype of thyroid cancer accounting for more than 80% of all cases. A single size threshold of 4 cm maximized prognostic discrimination with tumors >4 cm associated with a five times higher risk of recurrence than those ≤4 cm. The purpose of this present study was to determine an effective treatment strategy for patients with small unilateral papillary thyroid carcinoma in a low risk group below tumor size ≤ 4 cm.

Papillary thyroid microcarcinoma and papillary thyreoid cancer at the Department of Surgery, EUC Clinic Zlín

2020 ◽  
Vol 99 (11) ◽  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Biological Behavior ◽  
Evidence Based ◽  
Papillary Thyroid ◽  
Invasive Procedures ◽  
The Czech Republic ◽  
Thyroid Microcarcinoma ◽  
Group 2 ◽  
Group 1

Introduction: Papillary thyroid cancer (PTC), especially micropapillary variant (MPTC), is the most common thyroid malignancy. Biological behavior is not aggressive and the patient’s prognosis is satisfactory. The objective of our comparative retrospective study was to evaluate whether the incidence is rising in the Region of Zlín and if less extensive approach was adopted by Czech endocrinologists. Methods: We compared 2 groups from years 2005–2008 and 2014–2018. The incidence of thyroid cancer, the PTC and the MPTC, the extent of the surgery and the lymphadenectomy, number of removed lymph nodes and the number of positive lymph nodes were observed. Results: We gathered 1353 patients in group 1. We found 220 malignancies (16.3%), 180 (81.8%) were PTC with MPTC variant in 44.4% (80 patients). All patients underwent a total thyroidectomy. We made 18 central and 10 lateral lymphadenectomies, 280 lymph nodes were collected with metastasis in 29,3 %. In group 2 with 1569 patients we found 318 (20.3%) carcinomas, PTC in 302 (94.6%) cases. The MPTC accounted for 215 (67.4%) cases. 10 patients with MPTC underwent hemithyroidectomy only. Numbers of central and lateral lymphadenectomies rose to 52 and 24 respectively. We gathered 376 lymph nodes with proven metastasis in 44.4% of these nodes. Conclusion: Both, the incidence and the frequency of PTC and MPTC are rising in our region. However, the number of less invasive procedures is not increasing significantly despite representing a sufficient way of treatment. We need wider adoption of these evidence-based recommendations by indicating endocrinologists in the Czech Republic.

scholarly journals Skeletal Muscle Metastasis in Papillary Thyroid Microcarcinoma Evaluated by F18-FDG PET/CT

Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 100 ◽  
Author(s):  
Hitu ◽  
Cainap ◽  
Apostu ◽  
Gabora ◽  
Bonci ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Thyroid Cancer ◽  
Erector Spinae ◽  
Biological Behavior ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Skeletal Muscle Metastasis ◽  
Thyroid Microcarcinoma ◽  
Muscle Metastasis ◽  
Skeletal Muscle Metastases

Papillary thyroid cancer (PTC) is the most common type of thyroid malignancy and is characterized by slow growth and an indolent biological behavior. Papillary thyroid microcarcinoma is the PTC with the maximum size of the tumor <1cm, considered the most indolent form of thyroid cancer. PTC is usually metastasizes in cervical lymph nodes, lungs and bones and, less commonly, in brain or liver. Skeletal muscle metastases from PTC are extremely rare, a retrospective review of the literature revealed only 13 case reports. Among them, six cases are solitary skeletal muscle metastases, and seven are multiple metastases, most of them being associated with lung lesions. It seems that PTC is prone to metastasizing to the erector spinae and thigh muscles groups with unique cases located in trapezoid, biceps, deltoid, gastrocnemius and rectus abdominis muscles. Although extremely rare, one must bear in mind the fact that muscle metastasis from PTC is possible, and that is the reason we would like to discuss the existing clinical cases and to add a unique case of solitary skeletal muscle metastasis from papillary microcarcinoma.

Papillary Thyroid Carcinoma: How Radical Lymphadenectomy Should be Performed?

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 63-68
Author(s):  
Schweizer ◽  
Seifert ◽  
Gemsenjäger
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Low Risk ◽  
Papillary Thyroid ◽  
Sentinel Nodes ◽  
Fand Sich ◽  
Radical Lymphadenectomy ◽  
N Status

Fragestellung: Die Bedeutung von Lymphknotenbefall bei papillärem Schilddrüsenkarzinom und die optimale Lymphknotenchirurgie werden kontrovers beurteilt. Methodik: Retrospektive Langzeitstudie eines Operateurs (n = 159), prospektive Dokumentation, Nachkontrolle 1-27 (x = 8) Jahre, Untersuchung mit Bezug auf Lymphknotenbefall. Resultate: Staging. Bei 42 Patienten wurde wegen makroskopischem Lymphknotenbefall (cN1) eine therapeutische Lymphadenektomie durchgeführt, mit pN1 Status bei 41 (98%) Patienten. Unter 117 Patienten ohne Anhalt für Lymphknotenbefall (cN0) fand sich okkulter Befall bei 5/29 (17%) Patienten mit elektiver (prophylaktischer) Lymphadenektomie, und bei 2/88 (2.3%) Patienten ohne Lymphadenektomie (metachroner Befall) (p < 0.005). Lymphknotenrezidive traten (1-5 Jahre nach kurativer Primärtherapie) bei 5/42 (12%) pN1 und bei 3/114 (2.6%) cN0, pN0 Tumoren auf (p = 0009). Das 20-Jahres-Überleben war bei TNM I + II (low risk) Patienten 100%, d.h. unabhängig vom N Status; pN1 vs. pN0, cN0 beeinflusste das Überleben ungünstig bei high risk (>= 45-jährige) Patienten (50% vs. 86%; p = 0.03). Diskussion: Der makroskopische intraoperative Lymphknotenbefund (cN) hat Bedeutung: - Befall ist meistens richtig positiv (pN1) und erfordert eine ausreichend radikale, d.h. systematische, kompartiment-orientierte Lymphadenektomie (Mikrodissektion) zur Verhütung von - kurablem oder gefährlichem - Rezidiv. - Okkulter Befall bei unauffälligen Lymphknoten führt selten zum klinischen Rezidiv und beeinflusst das Überleben nicht. Wir empfehlen eine weniger radikale (sampling), nur zentrale prophylaktische Lymphadenektomie, ohne Risiko von chirurgischer Morbidität. Ein empfindlicherer Nachweis von okkultem Befund (Immunhistochemie, Schnellschnitt von sampling Gewebe oder sentinel nodes) erscheint nicht rational. Bei pN0, cN0 Befund kommen Verzicht auf 131I Prophylaxe und eine weniger intensive Nachsorge in Frage.

scholarly journals Decision-making in Surgery or Active Surveillance for Low Risk Papillary Thyroid Cancer During the COVID-19 Pandemic

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 371
Author(s):  
Anna Sawka ◽  
Sangeet Ghai ◽  
Ogemdi Ihekire ◽  
Jennifer Jones ◽  
Amiram Gafni ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Active Surveillance ◽  
Low Risk ◽  
Observational Research ◽  
Papillary Thyroid ◽  
Missed Appointments ◽  
Physician Visits ◽  
Observational Cohort ◽  
Study Participants

We describe our experience conducting a prospective observational cohort study on the management of small, low risk papillary thyroid cancer during the COVID-19 pandemic. Our study participants are given the choice of active surveillance (AS) or surgery, and those in the AS arm are followed at the study center, whereas surgical patients undergo usual care. During the pandemic we have transitioned from in-person research patient visits to largely virtual care of patients under AS. As of 30 October 2020, we had enrolled 181 patients enrolled in our study (including 25 during the pandemic), of which 92.3% (167/181) consented to telephone communication and 79.0% (143/181) consented to secure videoconferencing communication. Prior to the pandemic, 74.5% (117/157) of our patients chose AS over surgery, whereas during the pandemic, 96.0% (24/25) chose AS. Of the 133 study patients who were under AS within the timeframe from 12 March 2020, to 30 October 2020, the percentage of patients who missed appointments was 8.3% (11/133, for neck ultrasound and physician visits, respectively) and delayed appointments was 23.3% (31/133). This preliminary data suggests that prospective observational research on AS of thyroid cancer can safely continue during the pandemic.

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