Μυελοειδές καρκίνωμα θυρεοειδούς σαν τυχαίο εύρημα μετά από λοβεκτομή

PAPILLARY THYROID MICROCARCINOMA (PTMC) – A COMMON CLINICAL ENTITY, BUT NOT ALWAYS ‘INNOCENT’

PTMC is defined as papillary thyroid cancer (PTC) measuring less than 1 cm in size. PTMCs are very common and are detected in up to 30 % in autopsy studies. In the past, PTMCs were more commonly incidentally diagnosed during histological examination of the specimen following thyroidectomy even for a presumably benign disease (in up to 15 – 20 % of patients), but they are now increasingly detected by high-resolution ultrasonography. PTMCs have excellent prognosis, with 10-year or even 15-year disease specific survival rates exceeding 99 %. However, PTMCs may occasionally have a more aggressive clinical behavior and 0.5 % of patients will die of the disease. Recognized risk factors of mortality from a PTMC include:

1.Age older than 45 years

2.Male sex

3.African American or minority race

4.Lymph node metastases (no uncommon, in up to 50 % of patients, usually microscopic)

5.Extrathyroidal extension

6.Distant metastases

7.Intraglandular spread or multifocality

8.BRAF positivity

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.

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