THYROID PAPILLARY MICROCARCINOMA

Treatment of thyroid differenciated carcinoma is controversial. In cas e of papillary microcarcinoma a low malignancy is usually considered a nd a limited surgical excision is currently used. We describe 49 cases with papillary tumor < 1 cm. Their high frequency (51% of all differe nciated carcinoma discovered in the same period), current mode of thei r diagnosis (incidental histological findings: N = 48), and constant t umoral situation in extra nodular parenchyma are emphasised. In spite of median tumor size < 2 mm, 8 % had extra thyroidal tumoral extent at diagnosis (node metastasis: N = 3; bone: N = 1). In one case with mul tifocal lesions in both lobes, an unilateral thyroidectomy would have missed controlateral periglandular metastatic nodes. Diagnosis of the case with asymptomatic bone metastatis was clearly attributable to rad ioiodine therapeutic use. These results suggest an heterogeneous progn osis of papillary microcarcinoma, with some cases requiring total bila teral thyroidectomy and radioiodine remnants ablation (e.g. Tumors inv ading peripheral thyroid tissue that seem at higher risk of extra glan dular extension).