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Title: Not all occult papillary carcinomas are minimal

Occult papillary carcinomas are characterized as small papillary tumors of less than 1.5 cm in maximum diameter, with or without bulky metastatic deposits in cervical nodes. The primary lesion is usually not palpable, and although the clinical behavior usually follows a benign course, tumors with unfavorable histologic features (invasiveness, multifocality) or extrathyroidal disease or a combination of both may not do so. In this report six cases are presented to illustrate this entity. No patient had a history of irradiation to the head or neck. All had primary lesions smaller than 1.5 cm. None had a palpable nodule or abnormal thyroid scan results, and the diagnosis of thyroid cancer was based on cervical lymph node or lung biopsy specimens, which revealed papillary thyroid cancer. All of the patients underwent total or near-total thyroidectomies and were found to have small, invasive papillary lesions with additional metastases to cervical nodes noted at the time of thyroidectomy. Adjunctive treatment consisted of a 5 mCi iodine-131 scan, ablative iodine-131 therapy, and suppression with L-thyroxine. Although distant metastasis to lung or other organs is uncommon and the mortality rate is low (as in larger papillary cancers), these invasive lesions--despite their small size--have a high propensitymore » for recurrence and should be considered to behave more like encapsulated papillary tumors with extrathyroidal extension than like their small, unencapsulated intrathyroidal counterparts.« less
Authors:
; ;
Publication Date:
OSTI Identifier:
6610694
Resource Type:
Journal Article
Resource Relation:
Journal Name: Surgery; (United States); Journal Volume: 104:6
Research Org:
Johns Hopkins Hospital, Baltimore, MD (USA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; DIAGNOSIS; THYROID; IODINE 131; LUNGS; LYMPH NODES; METASTASES; PATIENTS; RADIOISOTOPE SCANNING; RADIOTHERAPY; SURGERY; THYROIDECTOMY; THYROXINE; AMINO ACIDS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARBOXYLIC ACIDS; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DISEASES; ENDOCRINE GLANDS; GLANDS; HORMONES; INTERMEDIATE MASS NUCLEI; IODINE ISOTOPES; ISOTOPES; LYMPHATIC SYSTEM; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANIC HALOGEN COMPOUNDS; ORGANIC IODINE COMPOUNDS; ORGANS; PEPTIDE HORMONES; RADIOISOTOPES; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY; THYROID HORMONES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics; 550600 -- Medicine; 550604 -- Medicine-- Unsealed Radionuclides in Therapy-- (1980-)