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The incidence of thyroid papillary microcarcinoma appears to be increasing and therapeutic modalities remain controversial. This retrospective study concerns 25 cases, from 1978 to 1999. The circumstances of diagnosis were: a cervicotomy for thyroid nodule (88% of cases), cervical node metastases (8%), and osseous metastases (4%). The sensitivity of ultrasounds was 22.2%, that of scintigraphy was 9.1% and that of extemporaneous histological examination was 18.2%. Multifocality was found in 16% of cases and bilaterality in 16.6%. Treatment modalities were guided by histological examination. Adjunctive radioiodine ablation was used for 20% of the patients. The treatment of the osseous metastases was completed with external irradiation. The average follow up was 4.8 years (4 months to 19 years), with a rate of survival without disease of 100%.

Perfusion lung scintigraphy is vital to guide the diagnosis even without a ventilation scintigraphy. A customised strategy could be useful to optimise the use of perfusion scintigraphy when not coupled with a ventilation scintigraphy. We report about a retrospective study on 300 patients received in our department for suspected lung migrations. The patients underwent a perfusion scintigraphy only: a normal scintigraphy would discard the diagnosis when achieved between 6 and 72 hours after the accident. On the other hand, the evidence of one or two perfusion defects would allow to maintain the pulmonary embolism suspicion and establish an effective heparinic treatment. A second control comparative scintigraphy, a few weeks after the first one, very often confirms the diagnosis, allows the assessment of the heparinotherapy and if necessary, indicate to stop it.