The Incidence of Papillary Thyroid Microcarcinoma in Patients Who underwent Total Thyroidectomy due to Benign Diseases and Our Clinical Approach

Özet

Introduction: To present our experience with incidental papillary thyroid microcarcinoma (PTMC) in patients operated for presumably benign thyroid disease. Methods: The files of 201 patients operated by the same surgeon for benign thyroid diseases from May 2014 to November 2017 were reviewed retrospectively. All had benign fine needle aspiration cytology and underwent total thyroidectomy. Data regarding demographics, pathology findings, management and outcomes were retrieved. Results: The mean age of the patients was 46 years (range:17-78) and 159 (79.1%) of them were female. Twenty-five patients (12.4%) with incidental PTMC were evaluated. Mean diameter of PTMC was 4.7±2.4 mm. In 6 patients (6/25, 24%), the tumor was multifocal and in half of these, tumor foci were found in both lobes. In one patient, tumor infiltrated the capsule. All patients received suppressive therapy and referred to the nuclear medicine department for possible radioiodine therapy. One case with capsule infiltration and 3 patients with multifocal tumor (16%) received radioiodine. Mean follow-up was 2.6 years (range, 4-44 months). All patients were alive and disease-free. Discussion and Conclusion: PTMC is not an uncommon incidental finding after surgery for presumably benign thyroid disease. The possibility of an underlying PTMC should be taken into account in the management and total thyroidectomy should be considered at least in selected patients.