title: 'Aggressive papillary' thyroid microcarcinoma.
abstract: The objective of this study is to highlight the fact that papillary thyroid microcarcinoma can be aggressive, requiring therapeutic management similar to that of other differentiated thyroid cancers. This 8-year retrospective study concerned 187 surgical patients managed in an ENT and Head and Neck surgery department for thyroid cancer. 65 patients were found to have papillary microcarcinoma. 41 microcarcinomas were considered to be aggressive because of the presence of several risk factors such as larger than 5 mm, multifocal microcarcinomas, capsular effraction, vascular embolus, tumour extension beyond the thyroid parenchyma and metastatic lymphadenopathy. All patients with aggressive papillary microcarcinoma were treated by total thyroidectomy and (131)I. Ipsilateral recurrent laryngeal and lateral cervical lymph node dissections were performed in ten patients, ipsilateral cervical lymph node dissection was performed in six patients and bilateral recurrent laryngeal and lateral cervical lymph node dissections were performed in three patients. No recurrence or metastasis was observed (follow-up ranging from 6 months to 8 years). The optimal management of thyroid papillary microcarcinoma is still controversial. "Aggressive" papillary thyroid microcarcinoma is not rare and may justify aggressive treatment depending on the presence or absence of prognostic risk factors.
authors.affiliation: Department of Anatomy, University Medical School of Amiens, University of Picardie Jules Verne, Amiens, France. cyril.page@caramail.com
authors.forename: Cyril
authors.initials: C
authors.lastname: Page
authors.forename: Aurélie
authors.initials: A
authors.lastname: Biet
authors.forename: Pierrick
authors.initials: P
authors.lastname: Boute
authors.forename: Philippe
authors.initials: P
authors.lastname: Cuvelier
authors.forename: Vladimir
authors.initials: V
authors.lastname: Strunski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult