FACTORS
ASSOCIATED WITH A MORE AGGRESSIVE BIOLOGICAL BEHAVIOR IN PAPILLARY MICROSCOPIC THYROID
CARCINOMA (PMTC)
Papillary microscopic
thyroid carcinoma (PMTC) is defined as papillary thyroid cancer (PTC) measuring
< 10 mm. In the past, PTMC was more commonly an incidental finding on
histopathological examination after thyroidectomy performed for a presumably
benign disease (such as multinodular goiter). Currently, however, PMTC is increasingly
diagnosed preoperatively, based on the findings of high-resolution ultrasography
and fine-needle aspiration (FNA) cytology. PMTC are believed to have an
excellent prognosis, but some may behave more aggressively than previously
appreciated. Indeed, lymph node and distant metastases may be present in up to
30 % and 0.6 % of patients at the time of diagnosis. Moreover, 3.5 % of
patients will experience disease recurrence.
Risk
factors associated with a more aggressive biological behavior of PMTC include:
1.Age older
than 45 years
2.Male sex
3.Lymph
node metastases (especially in the presence of extralymphatic spread)
4.Extrathyroidal
extension (may occur when the PMTC is superficially located)
5.Intraglandular
spread / multifocality
6.Extensive
fibrosis (intra-/peri-tumoral)
7.BRAF
positivity
8. African
American or minority race
The
presence of 2 or more risk factors is strongly associated with cancer-related
mortality and can help to identify patients who should be considered for more
aggressive management.
Σχόλια
Δημοσίευση σχολίου