April - June 2023, Volume 19, Issue 2

Dimov R, Kostov G, Doykov M, Hristov B

Papillary Microcarcinoma of the Thyroid Gland - Does Size Matter?

Acta Endo (Buc) 2023, 19 (2): 163-168
doi: 10.4183/aeb.2023.163

Introduction. Papillary thyroid microcarcinoma has provoked discussion among the endocrinological community due to the extremely diverse therapeutic methods adopted in international guidelines. From the radical approach of total thyroidectomy with prophylactic central lymphatic dissection to "active monitoring" and opinions such as "papillary microcarcinoma is not carcinoma". Aim. To investigate the factors of invasiveness in papillary microcarcinoma. Material and methods. We included 184 patients with thyroid microcarcinoma, operated in the Department of General Surgery "Kaspela",Plovdiv, for a period of five years. Results. Intra-organ metastases or multifocal growth was identified in 38 of the patients. Positive for micro and macro metastases lymph nodes in the central lymphatic basin are found in 54. In 46 of them we identified metastases in the ipsilateral, and in 21 in the contralateral central neck nodes. The analysis of patients with lateral metastases found 7 unilaterally and 3 bilaterally. Skip metastases were registered in 4 of these 10 patients. Conclusions. The results of our study show that despite the favorable prognosis and non-aggressive behavior of papillary microcarcinoma, factors attesting to the invasive nature of the tumor occur in 44.5% or almost half of patients. This requires careful and individual approach constructing therapeutic strategy for the treatment of patients with papillary microcarcinoma

Keywords: papillary microcarcinoma, central neck lymph nodes, capsular invasion.

Correspondence: Gancho Kostov MD, Medical University of Plovdiv Hospital, Surgery, zhk Hristo Smirnenski, Sofia 64 street, Plovdiv, 4002, Bulgaria, E-mail: caspela@abv.bg