title: Identification of occult tumors by whole-specimen mapping in solitary papillary thyroid carcinoma.
abstract: We undertook this study to estimate an accurate incidence and spread patterns of occult papillary thyroid carcinoma (PTC) in patients with a preoperative diagnosis of solitary PTC by using whole-specimen mapping of all specimens after a total thyroidectomy. Enrolled prospectively in this whole-thyroid mapping study are 82 consecutive patients who underwent a total thyroidectomy under a preoperative diagnosis of solitary PTC. All thyroidectomy specimens were serially sectioned in 2 mm thickness and whole-thyroid mapping was carried out for additional foci of occult PTC. The frequencies of occult lesions detected in the whole and contralateral lobe were determined, and clinicopathologic factors associated with multifocality were assessed. Whole-thyroid mapping revealed 66 occult PTC lesions missed by preoperative ultrasound in 37 (45.1%) of the 82 patients. The great majority (92.5%) of the occult PTC was smaller than 3 mm in size and 25 patients (30.5%) had contralateral lesions. We found that the male sex was an independent predictor of multifocality (odds ratio (OR), 3.00; 95% CI, 1.11-8.14), adjusting for preoperative findings. Analysis with pathologic parameters showed that the male sex (OR, 5.03; 95% CI, 1.68-15.08) and extrathyroidal extensions (OR, 3.03; 95% CI, 1.03-8.95) were associated with multifocal PTC. However, none of the clinicopathologic factors evaluated predicted contralateral PTC. Our study demonstrates the diagnostic limitations of ultrasound for the detection of multifocal PTC and the need to consider the possibility of occult lesions in the management of solitary PTC, especially in male patients.
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Seog Yun
authors.initials: SY
authors.lastname: Park
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Yuh-S
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Ryu
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Chang Yoon
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Lee
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Seok-Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Kim
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Jeyun
authors.initials: J
authors.lastname: Jang
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Daeyoon
authors.initials: D
authors.lastname: Park
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Seung Myung
authors.initials: SM
authors.lastname: Dong
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Jae-Goo
authors.initials: JG
authors.lastname: Kang
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Center for Thyroid CancerCenter for Lung CancerResearch InstituteNational Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of KoreaDepartment of Otolaryngology-Head and Neck SurgeryNational Medical Center, Seoul, Republic of Korea jsryu@ncc.re.kr.
authors.forename: Junsun
authors.initials: J
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D013965:Thyroidectomy; D014463:Ultrasonography; D055815:Young Adult
keywords: multifocal; occult; papillary thyroid carcinoma; thyroid; whole-specimen mapping