RATIONAL MANAGEMENT OF PAPILLARY MICROCARCINOMA OF THE THYROID

概要

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Although the mortality rate associated with papillary thyroid microcarcinoma (PMC) is generally very low, and most of them are regarded as "innocent" cancers, it is still controversial how to deal with PMC when it is detected incidentally. We had routinely attempted to perform surgery, and 178 patients with PMC underwent thyroidectomy between 1976 and 1993. Among them, 148 patients who had neither cervical lymphadenopathy nor recurrent laryngeal nerve palsy had a distinctly favorable outcome. Our strategy for patients with asymptomatic PMC changed in 1995, to conservative following of their courses, carefully using ultrasonography. Until 1999, 35 patients with 44 PMC lesions agreed with our policy. The duration of follow-up ranged from 1 to 10 years. Although 8 lesions (18%) increased over 50% in their volume, no patient developed clinically apparent nodal metastasis, distant metastasis, or extrathyroidal invasion. The encapsulated lesions and carcinomas with capsular calcification showed little change in tumor size.
日本頭頸部癌学会の論文