'Incidental' and 'non-incidental' thyroid papillary microcarcinomas are two different entities. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Provenzale, Maria Annateresa; Fiore, Emilio; Ugolini, Clara; Torregrossa, Liborio; Morganti, Riccardo; Molinaro, Eleonora; Miccoli, Paolo; Basolo, Fulvio; Vitti, Paolo
• Is Part Of: European journal of endocrinology. Volume 174:Issue 6(2016)
• Page Start: 813
• Page End: 820
• Publication Date: 2016-06
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EJE-15-1223
• Languages: English
• ISSNs: 0804-4643

Abstract

Abstract : Objective: Papillary thyroid microcarcinomas (microPTC) may be 'incidental' (Inc-microPTC), occasionally found at histology after surgery for benign disease or 'non-incidental' (Non-Inc-microPTC), diagnosed on clinical grounds. It is unclear whether these different microPTC reflect the same disease. The aim of the study was to compare Inc-microPTC and Non-Inc-microPTC for clinical and histological features as well as for serum TSH, a known factor involved in PTC development. Design: We evaluated histology and serum TSH levels of consecutive patients submitted to thyroidectomy for goiter with compressive symptoms or for cytological diagnosis suspicious/indicative of PTC. Methods: In total, 665 consecutive patients (259 with a single thyroid nodule, SN and 406 with a multinodular gland, MN) were included in the study. According to histology, patients were classified as: benign nodular goiter (Benign, n =291); Inc-microPTC ( n =92); Non-Inc-microPTC ( n =67) and PTC≥1cm (macroPTC, n =215). Results: Inc-microPTC were significantly more frequent in MN than in SN (66/406, 16.2% vs 26/259, 10.0%, P =0.02). Patients with Inc-microPTC compared with Non-Inc-microPTC were older (mean age±s.d. 53.3±13.2 years vs 44.9±14.8 years, P =0.0002), had a smaller tumor size (median 4mm vs 9mm, P <0.0001), a higher frequency of multifocality (70/92, 76.1% vs 35/67, 52.2% P =0.001) and lower levels of TSH (median 0.6mIU/L, IR: 0.4–1.0mIU/L vs value 1. mIU/L, IR: 0.6–1.4mIU/L vs P =0.0001). Conclusion: Incidental and non-incidental papillary thyroid microcarcinomas appear to be two different entities.