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  • Author: You Jin Lee x
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Seog Yun Park Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Yuh-S Jung Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Chang Hwan Ryu Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Chang Yoon Lee Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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You Jin Lee Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Eun Kyung Lee Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Seok-Ki Kim Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Tae Sung Kim Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Tae Hyun Kim Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Jeyun Jang Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Daeyoon Park Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Seung Myung Dong Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Jae-Goo Kang Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Jin Soo Lee Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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Junsun Ryu Center for Thyroid Cancer, Center for Lung Cancer, Research Institute, Department of Otolaryngology‐Head and Neck Surgery

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We undertook this study to estimate an accurate incidence and spread patterns of occult papillary thyroid carcinoma (PTC) in patients with a preoperative diagnosis of solitary PTC by using whole-specimen mapping of all specimens after a total thyroidectomy. Enrolled prospectively in this whole-thyroid mapping study are 82 consecutive patients who underwent a total thyroidectomy under a preoperative diagnosis of solitary PTC. All thyroidectomy specimens were serially sectioned in 2 mm thickness and whole-thyroid mapping was carried out for additional foci of occult PTC. The frequencies of occult lesions detected in the whole and contralateral lobe were determined, and clinicopathologic factors associated with multifocality were assessed. Whole-thyroid mapping revealed 66 occult PTC lesions missed by preoperative ultrasound in 37 (45.1%) of the 82 patients. The great majority (92.5%) of the occult PTC was smaller than 3 mm in size and 25 patients (30.5%) had contralateral lesions. We found that the male sex was an independent predictor of multifocality (odds ratio (OR), 3.00; 95% CI, 1.11–8.14), adjusting for preoperative findings. Analysis with pathologic parameters showed that the male sex (OR, 5.03; 95% CI, 1.68–15.08) and extrathyroidal extensions (OR, 3.03; 95% CI, 1.03–8.95) were associated with multifocal PTC. However, none of the clinicopathologic factors evaluated predicted contralateral PTC. Our study demonstrates the diagnostic limitations of ultrasound for the detection of multifocal PTC and the need to consider the possibility of occult lesions in the management of solitary PTC, especially in male patients.

Article Type:
Research Article
DOI:
https://doi.org/10.1530/ERC-15-0152
Volume/Issue:
Volume 22: Issue 4
Free access