title: Multifocality in well-differentiated thyroid carcinomas calls for total thyroidectomy.
abstract: BACKGROUND
  Multifocality is an important factor when recommending surgery for papillary thyroid cancer (PTC). The aim of this study is to assess the incidence and characterize the spread pattern of multifocal PTC (mPTC) in patients undergoing total thyroidectomy.
  
  
  METHODS
  All thyroidectomies performed between 2003 and 2008 were reviewed identifying 289 patients. Data were obtained for demographics, clinical data, and histopathological findings.
  
  
  RESULTS
  Of the patients with papillary carcinoma, mPTC was identified in 150 patients (57%), of which 71% had lesions in the contralateral lobe. There were no significant differences in multifocality rate for gender, pathology type, and all tumor size subgroups including ≤1 cm. Pathology examination of representative sections versus the entire gland examination resulted in a significantly lower incidence of contralateral disease (P = .04).
  
  
  CONCLUSIONS
  Multifocal and contralateral lesions are common in PTC and their incidence is not related to tumor size. Pathology entire gland examination is strongly recommended to properly assess the rate of mPTC.
authors.affiliation: Department of Surgery, Hadassah, Hebrew University Medical Center, Mount Scopus and Hebrew University, Hadassah Medical School, Jerusalem, State of Israel. haggi.mazeh@gmail.com
authors.forename: Haggi
authors.initials: H
authors.lastname: Mazeh
authors.forename: Yacov
authors.initials: Y
authors.lastname: Samet
authors.forename: David
authors.initials: D
authors.lastname: Hochstein
authors.forename: Ido
authors.initials: I
authors.lastname: Mizrahi
authors.forename: Ilana
authors.initials: I
authors.lastname: Ariel
authors.forename: Ahmed
authors.initials: A
authors.lastname: Eid
authors.forename: Herbert R
authors.initials: HR
authors.lastname: Freund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult