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6 - Papillary thyroid microcarcinomas in nodular goiter
Mehmet Uludağ, Gürkan Yetkin, Bülent Çitgez, Banu Yılmaz, Adnan İşgör, Abut Kebudi
Objective: To evaluate the papillay microcarcinoma incidence and the treatment options in the patients that we operated for nodular goiter.
Study design: The datas for 215 patients who has been examined with the diagnosis of nodular goiter and has been operated in our clinic in the period of 2002-2004 were rewiewed retrospectively
Results: In the 215 patients a total of 15 papillary thyroid micro- carcinoma was detected and the incidence was %6.98 . The mean age of the patients who has a tumor was 46.5 and 13 of them were women (%86.7). The mean diameter of the tumors was 0.41cm (0.1 -lcm). Extrathyroidal and capsular invasion was observed in the %13.3 of the patients. %6.6 of the tumors were multifocal and in %6.6 of them cervical lenf node metastase was found. The surgical procedures that were administered to these patients were I lobectomy, 6 total thyroidectomy,I near total thyroidectomy and in 7 cases total lobectomy plus subtotal lobectomy was made. In 3 of these patients completion thyroidectomy was necessary because of risk factors. In the mean fallow up of 22,6 months recurrence or mortality was not encountered.
Conclusions: Since the papillary thyroid microcarcinomas have a good prognose in the incidental cases which were found in subtotal thyroidectomy patients we recommend fallow up without additional treatment.In the cases who has risk factors related to the tumor our opinion is to perform a total thyroidectomy in order to achieve a safe oncological fallow up.
Keywords: incidental thyroid cancer, micropapillary thyroid cancer, thyroidectomy
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