Surgery, Gastroenterology and Oncology

Aim: The diagnosis of multicentric papillary microcarcinomas of the thyroid gland is often overlooked by preoperative diagnostic methods because of their small size, and the diagnosis is made by histopathological examination of the specimen after surgery.Appropriate surgical treatment should be performed to protect the patient from the risk of secondary surgery.The aim of this study is to determine multicentricity in patients with papillary microcarcinoma of the thyroid and the surgical treatment method that should be applied to these patients.

Materials Methods: Of 454 patients who underwent thyroid surgery, 163 patients whose histopathology was reported as thyroid cancer were retrospectively evaluated. Of these patients,113 had papillary microcarcinoma. The frequency of multicentricity of papillary microcarcinoma was investigated in the patient group of which medical records were examined. The patients were staged using MACIS, EORTC, and TNM, which are among the thyroid cancer staging systems.

Results: Multicentricity was found in 26 (23%) out of 113 papillary microcarcinoma patients. Six (23%) patients had more than 2 tumor foci. If more than one focus was detected in the same lobe, the incidence of cancer in the other lobe was 31%. Preoperative ultrasonography revealed bilateral multinodular thyroid gland in all patients.Ultrasonography aimed at revealing suspicious findings in terms of malignancy, and 41% of the patients had these findings. Of the 31 patients who underwent fine-needle aspiration biopsy, 20 (67%) were evaluated as benign, and 15 (27%) of 28 papillary microcarcinoma patients who underwent the frozen section procedure were evaluated as benign.

Conclusion: The high rate of multicentricity in papillary microcarcinoma should be considered in the determination of surgical treatment. It is recommended that thyroid ultrasonography should be performed meticulously to avoid multicentricity.

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