title: Clinical and pathological characteristics of incidental and nonincidental papillary thyroid microcarcinoma in 339 patients.
abstract: BACKGROUND
  We analyzed the incidence and the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) in a high prevalence region of goiter with the purpose to investigate differences between incidental and nonincidental PTMC.
  
  
  METHODS
  A total of 2236 patients who underwent total thyroidectomy from 2001 to 2009 were reviewed retrospectively. Papillary carcinoma was diagnosed in 583 patients. Of these, 339 patients with PTMC were included in the study. Clinicopathological features were evaluated by univariate and multivariate analysis.
  
  
  RESULTS
  The prevalence of incidental PTMC was 12% of all patients who underwent surgery for thyroid disease. Univariate analysis showed that bilaterality (p = .001), autoimmune thyroid disease (p = .049), size of tumor >5 mm (p < .001), multifocality (p < .001), lymph node metastasis (p < .001), and capsule invasion (p < .001) were significantly associated with nonincidental PTMC. The incidence of lymph node metastasis in incidental PTMC was 5% versus 33% in nonincidental, suggesting that the biological behavior may be different in the 2 categories.
  
  
  CONCLUSIONS
  Our results indicate that a high rate of PTMC presented 1 or more risk factors including multifocality, bilaterality, capsule invasion, and lymph node metastasis. Therefore, we suggest total thyroidectomy followed by adequate exploration of the central neck compartment for possible nodal involvement and resection as a safe therapeutic approach.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Venizeleio-Pananeio General Hospital, Herakleion, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vasileiadis
authors.forename: Theodore
authors.initials: T
authors.lastname: Karatzas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vasileiadis
authors.forename: Stylianos
authors.initials: S
authors.lastname: Kapetanakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Charitoudis
authors.forename: Efthimios
authors.initials: E
authors.lastname: Karakostas
authors.forename: Gregory
authors.initials: G
authors.lastname: Kouraklis
mesh_terms: D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D013965:Thyroidectomy
keywords: clinicopathological characteristics; incidental; nonincidental; papillary thyroid microcarcinoma; surgical treatment