Micromedullary thyroid cancer: how micro is truly micro? Journal Article
| Authors: | Pillarisetty, V. G.; Katz, S. C.; Ghossein, R. A.; Tuttle, R. M.; Shaha, A. R. |
| Article Title: | Micromedullary thyroid cancer: how micro is truly micro? |
| Abstract: | BACKGROUND: The aggressive nature of medullary thyroid cancer (MTC) is evidenced by its propensity to present early with lymph node (LN) metastases. The clinical significance of sporadic MTC < or =1 cm (micro-MTC) is not clearly defined. METHODS: We performed a retrospective review of the clinical, laboratory, and pathologic data for all patients treated or followed at our institution for sporadic micro-MTC from 1987 through 2008. RESULTS: A total of 18 patients met the criteria for inclusion in our study. All tumors were unifocal and C-cell hyperplasia distant from the tumors was uniformly absent. Fourteen (78%) patients underwent total thyroidectomy, and the remaining four (22%) patients with tumors < or =0.5 cm had lobectomy with isthmusectomy alone. Four (22%) patients were found to have LN metastases. However, none of the nine patients with tumors <0.5 cm had clinical evidence of LN metastases. Patients were followed for a median of 3.3 (mean, 4.5) years, and there were no deaths. Postoperative calcitonin levels were available for all patients, of whom 14 had normal levels (range, 0-3.9 pg/ml). The four patients with elevated postoperative calcitonin levels (range, 6.3-644 pg/ml) had tumors ranging from 0.7-0.9 cm in size. CONCLUSIONS: Tumors <0.5 cm were associated with a complete absence of clinically detectable nodal disease or elevated postoperative calcitonin levels. The complete absence of multifocal or bilateral disease argues against the need for completion thyroidectomy for sporadic micro-MTC. |
| Keywords: | treatment outcome; survival rate; retrospective studies; cancer staging; follow up; follow-up studies; lymph node metastasis; lymphatic metastasis; neoplasm staging; adenocarcinoma; metabolism; carcinoma, papillary; calcitonin; pathology; retrospective study; thyroidectomy; thyroid neoplasms; papillary carcinoma; thyroid tumor; adenocarcinoma, follicular; medullary carcinoma; carcinoma, medullary |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 16 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2009-10-01 |
| Start Page: | 2875 |
| End Page: | 2881 |
| Language: | English |
| PUBMED: | 19568813 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 30 November 2010" - "Source: Scopus" |
Citation Impact
MSK Authors
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489Ghossein -
700Shaha -
484Tuttle -
29Pillarisetty -
33
Katz
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