Identification of occult tumors by whole-specimen mapping in solitary papillary thyroid carcinoma.

Abstract:

:We undertook this study to estimate an accurate incidence and spread patterns of occult papillary thyroid carcinoma (PTC) in patients with a preoperative diagnosis of solitary PTC by using whole-specimen mapping of all specimens after a total thyroidectomy. Enrolled prospectively in this whole-thyroid mapping study are 82 consecutive patients who underwent a total thyroidectomy under a preoperative diagnosis of solitary PTC. All thyroidectomy specimens were serially sectioned in 2 mm thickness and whole-thyroid mapping was carried out for additional foci of occult PTC. The frequencies of occult lesions detected in the whole and contralateral lobe were determined, and clinicopathologic factors associated with multifocality were assessed. Whole-thyroid mapping revealed 66 occult PTC lesions missed by preoperative ultrasound in 37 (45.1%) of the 82 patients. The great majority (92.5%) of the occult PTC was smaller than 3 mm in size and 25 patients (30.5%) had contralateral lesions. We found that the male sex was an independent predictor of multifocality (odds ratio (OR), 3.00; 95% CI, 1.11-8.14), adjusting for preoperative findings. Analysis with pathologic parameters showed that the male sex (OR, 5.03; 95% CI, 1.68-15.08) and extrathyroidal extensions (OR, 3.03; 95% CI, 1.03-8.95) were associated with multifocal PTC. However, none of the clinicopathologic factors evaluated predicted contralateral PTC. Our study demonstrates the diagnostic limitations of ultrasound for the detection of multifocal PTC and the need to consider the possibility of occult lesions in the management of solitary PTC, especially in male patients.

journal_name

Endocr Relat Cancer

journal_title

Endocrine-related cancer

authors

Park SY,Jung YS,Ryu CH,Lee CY,Lee YJ,Lee EK,Kim SK,Kim TS,Kim TH,Jang J,Park D,Dong SM,Kang JG,Lee JS,Ryu J

doi

10.1530/ERC-15-0152

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

679-86

issue

4

eissn

1351-0088

issn

1479-6821

pii

ERC-15-0152

journal_volume

22

pub_type

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