title: [From macro to micro thyroid carcinoma: records of a clinical hospital from 1991 to 2010].
abstract: BACKGROUND
  The prevalence of thyroid cancer has increased, particularly in nodules smaller than 10 mm, probably due to the growing use of routine thyroid ultrasound. There is controversy about the biological behavior of micro carcinomas and the relevance of their early detection.
  
  
  OBJECTIVE
  To characterize the clinical presentation of thyroid cancer over 20 years in an University medical center and to evaluate the differences between macro and micro carcinomas.
  
  
  METHODS
  We reviewed 1547 surgical biopsy records of thyroid cancer in our institution obtained between 1991 and 2010.
  
  
  RESULTS
  We observed a sustained increase in the rate of thyroidectomies for thyroid cancer (per 1000 surgical procedures) in the study period. Papillary, follicular, mixed, medullary and anaplastic carcinomas were observed in 95, 3, 2, 0.5 and 0.1% of biopsies, respectively. The incidence of tumors of less than 10 mm (micro carcinoma) also increased. Those findings were associated with a significant decrease in tumor aggressiveness, determined by a low frequency of surgical margin involvement of thyroid capsule, perithyroid tissue invasion, vascular permeation and lymph node metastases.
  
  
  CONCLUSIONS
  The increased prevalence of thyroid cancer, especially of micro carcinomas, may reflect the greater use of diagnostic ultrasound or represent a real change in the biological behavior of this disease and our data suggest that further studies are needed to know the impact of early treatment in the outcome of those patients because of the real less histologic agressiveness of micro carcinomas.
authors.affiliation: Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile. mosso@med.puc.el
authors.forename: Lorena
authors.initials: L
authors.lastname: Mosso
authors.forename: Claudia
authors.initials: C
authors.lastname: Campusano
authors.forename: Hernán
authors.initials: H
authors.lastname: González
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Domínguez
authors.forename: Patricio
authors.initials: P
authors.lastname: Salman
authors.forename: Valeria
authors.initials: V
authors.lastname: Suazo
authors.forename: Antonieta
authors.initials: A
authors.lastname: Solar
authors.forename: Jaime
authors.initials: J
authors.lastname: Cerda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D015995:Prevalence; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult