Medullary thyroid microcarcinoma: a clinicopathologic retrospective study of 38 patients with no prior familial disease.
Thirty-eight patients (25 women, 13 men; mean age, 57.8 [32 to 91]) showing one or more medullary thyroid microcarcinomas (ie, < 1 cm), with no prior MEN II or medullary thyroid carcinoma history in their family, were reviewed. Follow-up was available for 29 patients (mean, 53.6 months [1 to 147]). 21 patients (72.4%) are alive and free of disease, four patients (13.8%) died during follow-up without disease, 2 patients are alive with disease (local recurrence and persistent hypercalcitoninemia) after 80 and 99 months, respectively, and 2 patients died of disease after 24 and 46 months. Most tumors were incidental pathological findings (19 of 38) or were discovered by systematic blood calcitonin measurement for a nodular thyroid disease (15 of 38). Only the four patients who had an unfavorable outcome were symptomatic cases (palpable micro-MTC, diarrhea, cervical lymph node metastasis and pulmonary metastatic disease). The two patients with metastatic disease at diagnosis died during follow-up. In univariate analysis, a symptomatic medullary thyroid carcinoma was a strong predictor of an unfavourable outcome (p < .00008), as were the preoperative calcitonin level (P = .007) and an elevated postoperative calcitonin level (P = .004). Among 30 histopathological criteria, only the presence of amyloid correlated with an unfavorable outcome (P = .018).
Guyétant
S
S
Department of Pathology, Médecine C, Centre Hospitalier Universitaire, Angers, France.
Dupre
F
F
Bigorgne
J C
JC
Franc
B
B
Dutrieux-Berger
N
N
Lecomte-Houcke
M
M
Patey
M
M
Caillou
B
B
Viennet
G
G
Guerin
O
O
Saint-Andre
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000378:metabolism; D018276:Carcinoma, Medullary / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000473:pathology*
D002116:Calcitonin