Authors: Yasuhiro Ito Akira Miyauchi Hitomi Oda Kaoru Kobayashi Minoru Kihara Akihiro Miya
Publish Date: 2015/08/05
Volume: 40, Issue: 3, Pages: 523-528
Abstract
Lowrisk thyroid papillary microcarcinomas PMCs without evidence of metastasis grow slowly if at all However we recommended surgery for tumors touching the trachea TR or located in the course of the recurrent laryngeal nerve RN Here we compared the cases of lowrisk PMC patients who underwent immediate surgery to cases of TR and RNinvolved PMCsWe enrolled 1143 lowrisk PMC patients who underwent immediate surgery in the years 2006–2014 The PMCs of 437 patients touched the TR on imaging studies 270 104 and 63 were graded as low intermediate and high risk respectively for TR invasion based on the angles between the tumor and the TR surface The tumor was in the course of the RN in 144 patients with 35 graded low risk and 109 high risk for RN invasion based on the normal rim of the thyroid in the direction of the RNInvasion of the TR cartilage was observed only in highrisk patients Peritracheal connective tissue was resected in 21 15 and 6 of the high intermediate and lowrisk patients respectively Significant invasion of the RN requiring complete resection was observed in only nine patients at high risk for RN invasion The incidence of TR invasion in high and intermediate patients and the incidence of RN invasion in the highrisk patients were significantly higher than those of the lowrisk patients Tumors 7 mm did not show TR or RN invasionAmong PMCs that touched the TR or were located in the course of the RN observation could be the first choice for tumors 7 mm and those ≥ 7 mm judged as low risk for TR or RN invasion However for PMCs with highrisk features immediate surgery after cytological diagnosis by a needle aspiration biopsy is recommended
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