Clinical and pathologie properties of small differentiated carcinomas of the thyroid gland

Ninety‐one small differentiated thyroid carcinomas less than 10 mm in size treated during the last 33 years were subjected to clinical study. In 44 of the 91 cases, tumor was found incidentally at surgery, while in the remaining 47 a thyroid mass was palpable before operation. A preoperative diagnos...

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Bibliographic Details
Published in:World journal of surgery 1991-07, Vol.15 (4), p.511-515
Main Authors: Iida, Futoshi, Sugenoya, Akira, Muramatsu, Akira
Format: Article
Language:English
Subjects:
Carcinoma
Differentiate Thyroid Carcinoma
Metastatic Lymph
Metastatic Lymph Node
Thyroid Carcinoma
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Summary:Ninety‐one small differentiated thyroid carcinomas less than 10 mm in size treated during the last 33 years were subjected to clinical study. In 44 of the 91 cases, tumor was found incidentally at surgery, while in the remaining 47 a thyroid mass was palpable before operation. A preoperative diagnosis of carcinoma could not be made in nodules less than 5 mm in size. Ultrasonographic examination is now extending the limits of exact diagnosis. Metastasis was found in 16 of 33 patients who had lymph nodes dissected. Metastatic lymph nodes were distributed in the same sites as those with thyroid carcinomas larger than 10 mm. Pathologic examination was carried out in 108 small carcinomas including cases from an affiliated hospital. Histologically, all of them were papillary or follicular carcinomas. The growth pattern of the tumors was divided into 5 groups: 23 were nonencapsulated sclerosing type, 29 encapsulated type without capsule invasion, 48 encapsulated type with capsule invasion, 4 the infiltrative type, and 4 the round type. Lymph node metastasis and intraglandular dissemination were found most frequently in the infiltrative type, followed by the encapsulated type with invasion. The results suggest the necessity of lymph node dissection and lobectomy for patients with these histological types of small carcinomas who had only local removal of the tumor. Résumé Quatre‐vingt un cancers de la thyroïde, de moins de 10 mm de diamètre, traités ces 33 dernières années ont été analysés. Dans 44 des 91 cas, la tumeur a été découverte fortuitement lors de la cervicotomie alors que dans 47 cas, une masse était cliniquement palpable avant l'intervention. Le diagnostic préopératoire de cancer n'était pas possible lorsque le diamètre de la tumeur était inférieur à 5 mm. L'échographie élargit actuellement les possibilités du diagnostic. Parmi les 33 patients qui ont eu un curage ganglionnaire, 16 avaient des métastases. La distribution des métastases était similaire à celle qu'on observait lorsque le diamètre de la tumeur est supérieur à 10 mm. L'examen anatomopathologique de 108 cas de cancer de petite taille a démontré que la plupart de ces tumeurs étaient du type papillaire ou folliculaire. Selon leur type de développement, on distinque 5 groupes: 23 faisaient partie du type non encapsulé sclérosant, 29 étaient du type encapsulant sans invasion de la capsule, 48 étaient du type encapsulé avec invasion de la capsule, 4 étaient du type infiltrant, and 4, du type circ
ISSN:0364-2313
1432-2323
DOI:10.1007/BF01675648