Endocrine Abstracts

Introduction

Papillary carcinoma is the most frequent histological form of malignant thyroid tumors, increasingly diagnosed at the microcarcinoma stage. Papillary microcarcinomas, often localized, are classified as very low risk.

Objective of the study

To describe the epidemiological and clinical characteristics, the evolutionary profile as well as to determine the predictive factors of recurrence of papillary microcarcinomas.

Methods

Retrospective study including 232 patients followed for papillary thyroid microcarcinomas collected at the Endocrinology and Diabetology department of Ibn Rochd Casablanca University Hospital, spread from 1986 to December 2019. The analysis was carried out by SPSS version 25 software.

Results

The mean age of our patients was 44.31 years, with a clear predominance of women (93.1% of cases). The most frequent symptomatology was cervical swelling in 88.36%, the discovery was fortuitous in 11.63%. In our series 71% patients had multinodular goiter, 1.7% followed for dysthyroidism, 26.7% had no personal history and 1 patient (0.6%) followed for Basedow’s disease. All patients had clinical and biological euthyroidism except 4 patients who had hyperthyroidism. All patients underwent total thyroidectomy with pathologic papillary thyroid microcarcinoma, the most frequent histological variant is the classic papillary with an average size of 4.5 mm. Multifocality was objectified in 70 patients. Lymph node dissection was performed in only 11 patients. Iratherapy was performed in 88 patients. The remission rate was objectified in 94%. The predictive factors of recurrence were multifocal character (P = 0.004), size > 5 mm (P = 0.002), and unencapsulated character (P = 0.001).

Conclusion

Papillary thyroid microcarcinomas have an excellent prognosis. However, certain predictive factors of aggressive evolution justify a surgical and isotopic maximalist attitude. The limitation of this study was the lack of the genetic study.