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Expert Opin Pharmacother. 2007 Dec;8(18):3205-15.

Appropriate treatment for asymptomatic papillary microcarcinoma of the thyroid.

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1
Kuma Hospital, Department of Surgery, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan. ito01@kuma-h.or.jp

Abstract

Since the 1990 s, asymptomatic papillary microcarcinoma (PMC), papillary carcinoma measuring <or= 1.0 cm, has frequently been detected using ultrasonographic screening and diagnosed by ultrasonography-guided fineneedle aspiration biopsy. Thyroid carcinoma was detected in 3.5% of otherwise healthy women aged >or= 30 years of age and most of these patients had lesions measuring <or= 1.5 cm in diameter, which is not discrepant with previous autopsy findings that latent PMC showed a high incidence. A recent observation trial showed that only 6.7% of low-risk PMC definitely became enlarged during 5 years of follow up, indicating that observation is an attractive alternative to surgery for PMC. However, PMC with clinically apparent metastasis detected on imaging is likely to show a recurrence to the lymph node and careful neck dissection as well as total thyroidectomy may be required. If surgical treatment is performed for low-risk PMC, prophylactic modified radical neck dissection is not necessary and lobectomy (with isthmectomy) and central node dissection is adequate if the tumor is located only in one lobe.

PMID:
18035964
DOI:
10.1517/14656566.8.18.3205
[Indexed for MEDLINE]
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