title: Surgical Management of Familial Papillary Thyroid Microcarcinoma: A Single Institution Study of 94 Cases.
abstract: BACKGROUND
  Familial papillary thyroid carcinoma (familial PTC) is well known to present with aggressiveness; however, the characteristics and the prognostic outcomes of familial papillary thyroid microcarcinoma (familial micro-PTC) are not well established. The overall aim of this study was to analyze the clinicopathological outcomes of familial micro-PTC.
  
  
  METHODS
  Between 1996 and 2006, 2071 patients underwent thyroid surgery for papillary thyroid carcinoma. The clinicopathological outcomes for familial PTC and sporadic PTC were compared, and familial micro-PTC data were sub-analyzed.
  
  
  RESULTS
  There were significant differences in multifocality, bilaterality, extent of surgery, and recurrence between familial PTC and sporadic PTC (p<0.05). There was no significant difference in the number of affected family members in the familial PTC group. In patients with familial micro-PTC, less aggressiveness was noted in multifocality, extrathyroidal invasion, tumor stage at time of initial surgery, central lymph node metastasis, and recurrence than in those with familial PTC tumors>1 cm in diameter (p<0.05). The multivariate analysis including recurrence showed no significant difference between familial micro-PTC patients and sporadic micro-PTC patients.
  
  
  CONCLUSIONS
  When familial PTC was compared with sporadic PTC, our results support the recommendation for more invasive familial PTC surgery. However, familial micro-PTC outcomes differed from familial PTC tumors>1.0 cm in diameter. It was similar to sporadic micro-PTC, illustrating that familial micro-PTC is less aggressive and that a less invasive surgical treatment could be considered.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea, tysung@amc.seoul.kr.
authors.forename: Tae-Yon
authors.initials: TY
authors.lastname: Sung
authors.forename: Yu-mi
authors.initials: YM
authors.lastname: Lee
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Yoon
authors.forename: Ki-Wook
authors.initials: KW
authors.lastname: Chung
authors.forename: Suck Joon
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009386:Neoplastic Syndromes, Hereditary / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods