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Multifocal papillary thyroid carcinoma--a consensus report of the European Society of Endocrine Surgeons (ESES).
- Source :
-
Langenbeck's archives of surgery [Langenbecks Arch Surg] 2014 Feb; Vol. 399 (2), pp. 141-54. Date of Electronic Publication: 2013 Nov 22. - Publication Year :
- 2014
-
Abstract
- Background: Multifocal papillary thyroid carcinoma (MPTC) has been reported in literature in 18-87 % of cases. This paper aims to review controversies in the molecular pathogenesis, prognosis, and management of MPTC.<br />Methods: A review of English-language literature focusing on MPTC was carried out, and analyzed in an evidence-based perspective. Results were discussed at the 2013 Workshop of the European Society of Endocrine Surgeons devoted to surgery of thyroid carcinoma.<br />Results: Literature reports no prospective randomized studies; thus, a relatively low level of evidence may be achieved.<br />Conclusions: MPTC could be the result of either true multicentricity or intrathyroidal metastasis from a single malignant focus. Radiation and familial nonmedullary thyroid carcinoma are conditions at risk of MPTC development. The prognostic importance of multifocal tumor growth in PTC remains controversial. Prognosis might be impaired in clinical MPTC but less or none in MPTC <1 cm. MPTC can be diagnosed preoperatively by FNAB and US, with low sensitivity for MPTC <1 cm. Total or near-total thyroidectomy is indicated to reduce the risk of local recurrence. Prophylactic central node dissection should be considered in patients with total tumor diameter >1 cm, or in cases with high number of cancer foci. Completion thyroidectomy might be necessary when MPTC is diagnosed after less than near-total thyroidectomy. Radioactive iodine ablation should be considered in selected patients with MPTC at increased risk of recurrence or metastatic spread.
- Subjects :
- Adenocarcinoma, Papillary diagnosis
Adenocarcinoma, Papillary genetics
Adenocarcinoma, Papillary pathology
Cell Transformation, Neoplastic genetics
Cell Transformation, Neoplastic pathology
Chernobyl Nuclear Accident
Combined Modality Therapy
DNA Mutational Analysis
Disease Progression
Europe
Neck Dissection
Neoplasm Staging
Neoplasms, Multiple Primary diagnosis
Neoplasms, Multiple Primary genetics
Neoplasms, Multiple Primary pathology
Neoplasms, Radiation-Induced diagnosis
Neoplasms, Radiation-Induced genetics
Neoplasms, Radiation-Induced pathology
Neoplasms, Radiation-Induced surgery
Prognosis
Radiotherapy, Adjuvant
Risk Factors
Thyroid Neoplasms diagnosis
Thyroid Neoplasms genetics
Thyroid Neoplasms pathology
Thyroidectomy
Adenocarcinoma, Papillary surgery
Neoplasms, Multiple Primary surgery
Thyroid Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1435-2451
- Volume :
- 399
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Langenbeck's archives of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 24263684
- Full Text :
- https://doi.org/10.1007/s00423-013-1145-7