EP21 – Aggressive Variants of Papillary Microcarcinoma

      Kim, Hyeung Kyoo1,2 ; Lee, Inhwa1; Lee, Jeonghun1; Chang, Hang-Seok2; Park, Cheong Soo1; Soh, Euy Young1 1 Department of Surgery, Ajou University School of Medicine, Suwon, South Korea 2 Department of Surgery, Gangnam severance hospital, Yonsei University College of Medicine, Seoul, South Korea   Background / Aims: The widespread use of ultrasonography and US-guided fine needle aspiration cytology (FNAC) which has led to diagnosis of small papillary carcinoma less than 10 mm in greatest dimension. One of the latest issues of PTMC has rising observation trial. And the other is not recommended FNAB in PTMC. But there is also aggressive pathologic type in PTMC. The aim of this study is to evaluate clinicopathologic features of aggressive variants PTMC and to comparison of the clinicopathologic characteristics of aggressive variants of PTMC and conventional PTMC. Methods: Between January 2009 and December 2014, 8,549 patients were analyzed. Of these patients, 120 had aggressive pathologic type (tall cell variant, diffuse sclerosing variant, solid variant) and 8,429 had conventional pathologic type. The clinicopathologic characteristics including gender, age, multiplicity, thyroiditis, capsule invasion, and nodal status of the two groups were compared. Results: The two groups were not different in regard to the gender. Aggressive pathologic type PTMC presented with significantly young age(p<0.001), multiplicity(p<0.001), thyroiditis(p<0.001), capsule invasion(0.003) and node metastasis(p<0.001); central node metastasis 87pts.(72.5%, p<0.001) and lateral node metastasis 33pts.(27.5%, p<0.001) compared to conventional pathologic type PTMC. Conclusion: Usually, PTMC have good prognosis and grows slowly. But. PTMC also have an aggressive variants pathology. It is dilemmas in the management of PTMC. We should reconsider that FNAB in PTMC was not recommended.   References:
    1. World J Surg (2010) 34:28-35 An Observational Trial for Papillary Thyroid Microcarcinoma in Japan Patients
    2. World J Surg (2010) 34:1222-1231 Three Distinctly Different Kinfds of Papillary Thyroid Microcarcinoma Should be Recognized: Our Treatment Strateges and Outcomes
    3. THYROID (2016) 26: 1-133 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid cancer
    4. Head Neck (2011) 33: 1052-1059 Aggresive variants of papillary thyroid carcinoma


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