Skip to main content Accessibility help
×
Home

Lymph node metastasis in thyroid papillary microcarcinoma: a study of 170 patients

  • R Varshney (a1), M N Pakdaman (a1), N Sands (a1), M P Hier (a1), L Rochon (a1), M J Black (a1) and R J Payne (a1)...

Abstract

Objective:

Papillary microcarcinoma of the thyroid has been described as either a normal variant or a serious malignancy. We describe our experience with papillary microcarcinoma and lymph node metastases.

Method:

A total of 685 consecutive total thyroidectomies with central compartment neck dissection were reviewed for papillary microcarcinoma. Association of central compartment lymph node metastases with age, gender, tumour multifocality, bilaterality and extrathyroidal extension was analysed.

Results:

Out of 170 papillary microcarcinoma cases, multifocality was found in 72 (42.4 per cent), bilaterality in 49 (28.8 per cent) and extrathyroidal extension in 16 (9.4 per cent). In all, 23 patients (13.5 per cent) had lymph node metastases. There was a significant association (p < 0.05) between extrathyroidal extension (but no other tumour characteristics) and lymph node metastases.

Conclusion:

In all, 13.5 per cent of papillary microcarcinomas in our series showed lymph node metastases. Lymph node metastases were associated with extrathyroidal invasion of the papillary microcarcinoma.

Copyright

Corresponding author

Address for correspondence: Dr R Varshney, McGill University, 59 Papillon, Dollard-des-Ormeaux, QC, CanadaH9B3M3 Fax: 001 514 421–5518 E-mail: rickul.varshney@gmail.com

References

Hide All
1Hedinger, C, Williams, ED, Sobin, LH. The WHO histological classification of thyroid tumors: a commentary on the second edition. Cancer 1989;63:908–11
2Ito, Y, Miyauchi, A. A therapeutic strategy for incidentally detected papillary microcarcinoma of the thyroid. Nat Clin Pract Endocrinol Metab 2007;3:240–8
3Pazaitou-Panayiotou, K, Capezzone, M, Pacini, F. Clinical features and therapeutic implication of papillary thyroid microcarcinoma. Thyroid 2007;17:1085–92
4McDougall, R, Camargo, CA. Treatment of micropapillary carcinoma of the thyroid: where do we draw the line? Thyroid 2007;17:1093–5
5Pelizzo, MR, Boschin, IM, Toniato, A, Piotto, A, Bernante, P, Pagetta, C et al. Papillary thyroid microcarcinoma (PTMC): Prognostic factors, management and outcome in 403 patients. Eur J Surg Oncol 2006;32:1144–8
6Chow, SM, Law, SCK, Chan, JKC, Au, SK, Yau, S, Lau, WH. Papillary microcarcinoma of the thyroid—prognostic significance of lymph node metastasis and multifocality. Cancer 2003;98:3140
7Roti, E, Rossi, R, Trasforini, G, Bertelli, F, Ambrosio, MR, Busutti, L et al. Clinical and histological characteristics of papillary thyroid microcarcinoma: results of a retrospective study in 243 patients. J Clin Endocrinol Metab 2006;91:2171–8
8Baudin, E, Travagli, JP, Ropers, J, Mancusi, F, Bruno-Bossio, G, Caillou, B et al. Microcarcinoma of the thyroid gland: the Gustave-Roussy Institute experience. Cancer 1998;83:553–9
9Fend, F, Gruber, U, Fritzsche, H, Rothmund, J, Breitfellner, G, Mikuz, G. Occult papillary carcinoma of the thyroid with pulmonary lymphangitic spread diagnosed by lung biopsy. Klin Wochenschr 1989;67:687–90
10Michie, HR, O'Bryan-Tear, CG, Marsh, H, Glazer, G. Cerebral metastases from occult papillary carcinoma of the thyroid. Br J Surg 1987;74:647
11Lin, KD, Lin, JD, Huang, MJ, Huang, HS, Jeng, LB, Chao, TC et al. Clinical presentations and predictive variables of thyroid microcarcinoma with distant metastasis. Int Surg 1997;82:378–81
12Lin, JD, Chen, ST, Chao, TZ, Hsueh, C, Weng, HF. Diagnosis and therapeutic strategy for papillary thyroid microcarcinoma. Arch Surg 2005;140:940–5
13Wada, N, Duh, QY, Sugino, K, Iwasaki, H, Kameyama, K, Mimura, T et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg 2003;237:399407
14Sampson, RJ, Oka, H, Key, CR, Buncher, CR, Iijima, S. Metastases from occult thyroid carcinoma. An autopsy study from Hiroshima and Nagasaki, Japan. Cancer 1970;25:803–11
15Gülben, K, Berberoğlu, U, Çelen, O, Mersin, HH. Incidental papillary microcarcinoma of the thyroid-factors affecting lymph node metastasis. Langenbecks Arch Surg 2008;393:25–9
16Kasai, N, Sakamoto, A. New subgrouping of small thyroid carcinomas. Cancer 1987;60:1767–70
17Pellegriti, G, Scollo, C, Lumera, G, Regalbuto, C, Vigneri, R, Belfiore, A. Clinical behavior and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: study of 299 cases. J Clin Endocrinol Metab 2004;89:3713–20
18Davies, L, Welch, HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295:2164–7
19Pakdaman, MN, Rochon, L, Gologan, O, Tamilia, M, Garfield, N, Hier, MP et al. Incidence and histopathological behavior of papillary microcarcinomas: study of 429 cases. Otolaryngol Head Neck Surg 2008;139:718–22
20Burman, KD. Micropapillary thyroid cancer: should we aspirate all nodules regardless of size? J Clin Endocrinol Metab 2006;91:2043–6
21Orsenigo, E, Beretta, E, Fiacco, E. Management of papillary microcarcinoma of the thyroid gland. Eur J Surg Oncol 2004;30:1104–6
22Ito, Y, Uruno, T, Nakano, K, Takamura, Y, Miya, A, Kobayashi, K et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid 2003;13:381–7

Keywords

Lymph node metastasis in thyroid papillary microcarcinoma: a study of 170 patients

  • R Varshney (a1), M N Pakdaman (a1), N Sands (a1), M P Hier (a1), L Rochon (a1), M J Black (a1) and R J Payne (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed