Appropriate treatment for asymptomatic papillary microcarcinoma of the thyroid.
Since the 1990 s, asymptomatic papillary microcarcinoma (PMC), papillary carcinoma measuring <or= 1.0 cm, has frequently been detected using ultrasonographic screening and diagnosed by ultrasonography-guided fineneedle aspiration biopsy. Thyroid carcinoma was detected in 3.5% of otherwise healthy women aged >or= 30 years of age and most of these patients had lesions measuring <or= 1.5 cm in diameter, which is not discrepant with previous autopsy findings that latent PMC showed a high incidence. A recent observation trial showed that only 6.7% of low-risk PMC definitely became enlarged during 5 years of follow up, indicating that observation is an attractive alternative to surgery for PMC. However, PMC with clinically apparent metastasis detected on imaging is likely to show a recurrence to the lymph node and careful neck dissection as well as total thyroidectomy may be required. If surgical treatment is performed for low-risk PMC, prophylactic modified radical neck dissection is not necessary and lobectomy (with isthmectomy) and central node dissection is adequate if the tumor is located only in one lobe.
Kuma Hospital, Department of Surgery, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan. ito01@kuma-h.or.jp
Yasuhiro
Y
Ito
Akira
A
Miyauchi
D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D006801:Humans; D033162:Incidental Findings; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use
D013972:Thyrotropin; D013974:Thyroxine