Endocrine Abstracts

Introduction: Follicular or vesicular cancers represent 5 to 10% of differentiated thyroid cancers (CTD) and are therefore the second leading cause of endocrine tumors after papillary thyroid cancer. They can be minimally or massively invasive, and thus represent a more aggressive histological type compared to the papillary. The aim of our work is to describe in our context the clinical and evolutionary features of thyroid tumors of vesicular origin.

Materials and methods: This is a retrospective descriptive study involving 27 patients, treated in the endocrinology department of Ibn Rochd University Hospital, Casablanca, between 1986 and 2018, and affected by a vesicular thyroid carcinoma. The statistical analysis was performed by the IBM SPSS Statistics 25 software.

Results: The average age of our patients was 47.5±13 years old. All patients in our study were women. The circumstances of discovery were in the majority of cases the presence of an isolated goiter (59%), followed by an isolated thyroid nodule (8%). Bone metastasis indicated the diagnosis in a patient. One patient consulted for a nasal voice with progressive aggravation and was diagnosed with a carcinoma on a lingual ectopic thyroid. All our patients underwent total thyroidectomy, lymph node excision was indicated only in one patient. Radioactive iodine treatment was done in 89% of the patients. All carcinomas in our series were uni focal. The size of the tumors ranged from 0.5 cm to 7.5 cm. The appearance of locoregional and distant metastases (bones, lungs) in one and two patients respectively, was noted. Two patients developed ductal carcinoma of the breast during follow-up. Complete remission was observed in 67% of patients. The occurrence of metastases was significantly correlated with vascular invasion (P=0.03)

Discussion: Thyroid tumors of vesicular origin represent the second most common histological type of malignant thyroid tumors after papillary cancers. Vital prognosis is rather good, and it is the risk of local or remote recurrence that will be relevant to guide the treatment. Among these risk factors: the histological variant of the tumor, the existence of local or regional metastases, or vascular or locoregional invasion. Thus, the degree of invasion of follicular cancers makes it possible to classify these tumors as low risk in case of minimal invasion, and as high risk in case of major invasion.