Papillary thyroid microcarcinoma: clinical study and prognosis

Abstract

Objective: To study the anatomical and prognostic characteristics of papillary thyroid microcarcinomas (10 mm or less in size).

Design: Retrospective review.

Setting: Community hospital, Spain.

Subjects: 36 patients with papillary microcarcinomas diagnosed over a period of 20 years from a total of 158 papillary carcinomas with complete follow-up.

Main outcome measures: Symptoms, treatment, histopathological confirmation and follow-up compared with those of papillary carcinomas more than 10 mm in size.

Results: Six of the patients with microcarcinomas presented with adenopathy, the remaining 30 being admitted for treatment of associated thyroid diseases. In 15 cases the tumour was 5 mm or less in size. Thirty were well-differentiated, 2 were follicular, and 2 showed signs of diffuse sclerosis. Three had recurred after total thyroidectomy, but no patient died. When the results were compared with those of the patients with larger tumours, we found differences in histological type (p = 0.001), the incidence of adenopathy (p = 0.03), TNM stage (p = 0.001) and mortality (p = 0.04).

Conclusions: There are clinical, histopathological, and prognostic differences between microcarcinomas (which do well) and larger papillary tumours.