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Management of Papillary Microcarcinoma of the Thyroid with A Short Column (Management of Tumors Diagnosed as Follicular Neoplasm on Cytology)

  • Yasuhiro ItoEmail author
  • Akira Miyauchi
  • Hitomi Oda
Chapter

Abstract

The definition of papillary microcarcinoma (PMC) by the WHO is papillary thyroid carcinoma (PTC) measuring 10 mm or less regardless of extension to adjacent organs (Ex), clinical lymph node metastasis (N), and distant metastasis (M). Low-risk PMC is defined as PMC without Ex, N, or M. Recent development of imaging techniques, especially ultrasound examination, has enabled us to detect small nodules measuring 3 mm or less. Additionally, ultrasound-guided fine needle aspiration cytology (FNAC) facilitated diagnosis of small nodules detected by ultrasound. Because of the prevalence of these techniques, PMC has been very frequently detected and diagnosed. Largely due to these developments, the incidence of thyroid cancer, especially of small PTC, is increasing globally without an increase in thyroid cancer mortality.

References

  1. 1.
    Ito Y, Miyauchi A. A therapeutic strategy for incidentally detected papillary microcarcinoma of the thyroid. Nat Clin Pract Endocrinol Metab. 2007;3:240–8.CrossRefGoogle Scholar
  2. 2.
    Takebe K, Date M, Yamamoto Y. Mass screening for thyroid cancer with ultrasonography [in Japanese]. KARKINOS. 1994;7:309–17.Google Scholar
  3. 3.
    Davies L, Welch HG. Increasing incidence of thyroid cancer in the Unites States, 1973–2002. JAMA. 2006;595:2164–7.CrossRefGoogle Scholar
  4. 4.
    Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140:317–22.CrossRefGoogle Scholar
  5. 5.
    Ahn HS, Kim HJ, Welch HG. Korea’s thyroid-cancer “epidemic” — screening and overdiagnosis. N Engl J Med. 2014;371:1765–7.CrossRefGoogle Scholar
  6. 6.
    Vaccarella S, Dal Maso L, Laversanne M, Bray F, Plummer M, Franceschi S. The impact of diagnostic changes on the rise in thyroid cancer incidence: a population-based study in selected high-resource countries. Thyroid. 2015;25:1127–36.CrossRefGoogle Scholar
  7. 7.
    Ito Y, Tomoda C, Uruno T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K, Miyauchi A. Papillary microcarcinoma of the thyroid: how should it be treated? World J Surg. 2004;28:1115–21.CrossRefGoogle Scholar
  8. 8.
    Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid. 2014;24:27–34.CrossRefGoogle Scholar
  9. 9.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2015;26:1–133.CrossRefGoogle Scholar
  10. 10.
    Uruno T, Miyauchi A, Shimizu K, Tomoda C, Takamura Y, Ito Y, Miya A, Kobayashi K, Matuzuka F, Amino N, Kuma K. Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer. World J Surg. 2005;29:483–5.CrossRefGoogle Scholar
  11. 11.
    Ito Y, Uruno R, Nakano K, Takamura Y, Miya A, Kobayashi K, Yokozawa T, Matsuzuka F, Kuma S, Kuma K, Miyauchi A. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid. 2003;13:381–8.CrossRefGoogle Scholar
  12. 12.
    Ito Y, Miyauchi A, Inoue H, Fukushima M, Kihara M, Higashiyama T, Tomoda C, Takamura Y, Kobayashi K, Miya A. An observation trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg. 2010;34:28–35.CrossRefGoogle Scholar
  13. 13.
    Ito Y, Kudo T, Kobayashi K, Miya A, Ichihara K, Miyauchi A. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5,768 patients with average 10-year follow-up. World J Surg. 2012;36:1274–8.CrossRefGoogle Scholar
  14. 14.
    Ito Y, Miyauchi A, Tomoda C, Hirokawa M, Kobayashi K, Miya A. Prognostic significance of young age in papillary thyroid carcinoma: analysis of 5,733 patients with 150 months’ follow-up. Endocr J. 2014;61:491–7.CrossRefGoogle Scholar
  15. 15.
    Miyauchi A, Kudo T, Kihara M, Higashiyama T, Ito Y, Kobayashi K, Miya A. Relationship of biochemically persistent disease and thyroglobulin-doubling time to age at surgery in patients with papillary thyroid carcinoma. Endocr J. 2013;60:415–21.PubMedGoogle Scholar
  16. 16.
    Sugitani I, Toda K, Yamada K, Yamamoto N, Ikenaga M, Fujimoto Y. Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg. 2010;34:1222–31.CrossRefGoogle Scholar
  17. 17.
    Miyauchi A. Clinical trials of active surveillance of papillary microcarcinoma of the thyroid. World J Surg. 2016;40:516–22.CrossRefGoogle Scholar
  18. 18.
    Fukuoka O, Sugitani I, Ebina A, Toda K, Kawabata K, Yamada K. Natural history of asymptomatic papillary thyroid microcarcinoma: time-dependent changes in calcification and vascularity during active surveillance. World J Surg. 2016;40:529–37.CrossRefGoogle Scholar
  19. 19.
    Ito Y, Kobayashi K, Tomoda C, Uruno T, Takamura Y, Miya A, Matsuzuka F, Kuma K, Miyauchi A. Ill-defined edge on ultrasonographic examination can be a marker of aggressive characteristic of papillary thyroid microcarcinoma. World J Surg. 2005;29:1007–11.CrossRefGoogle Scholar
  20. 20.
    Sugitani I, Fujimoto Y, Yamada K. Association between serum thyrotropin concentration and growth of asymptomatic papillary thyroid microcarcinoma. World J Surg. 2014;38:673–378.CrossRefGoogle Scholar
  21. 21.
    Hirokawa M, Kudo T, Ota H, Suzuki A, Miyauchi A. Pathological characteristics of low-risk papillary thyroid microcarcinoma with progression during active surveillance. Endocr J. 2016;63:805–10.CrossRefGoogle Scholar
  22. 22.
    Xing M, Liu R, Liu X, Murugan AK, Zhu G, Zeiger MA, Pai S, Bishop J. BRAF V600E and TERT promoter mutations cooperatively identify the most aggressive papillary thyroid cancer with highest recurrence. J Clin Oncol. 2014;32:2718–25.CrossRefGoogle Scholar
  23. 23.
    Matsuse M, Yabuta T, Saenko V, Hirokawa M, Nishihara E, Suzuki K, Yamashita S, Miyauchi A, Mitsutake N. TERT promoter mutations and Ki-67 labeling index as a prognostic marker of papillary thyroid carcinomas: combination of two independent factors. Sci Rep. 2017;7:417–52.CrossRefGoogle Scholar
  24. 24.
    Yabuta T, Matsuse M, Hirokawa M, Yamashita S, Mitsutake N, Miyauchi A. TERT promoter mutations were not found in papillary thyroid microcarcinomas that showed disease progression on active surveillance. Thyroid. 2017;27:1206–7.CrossRefGoogle Scholar
  25. 25.
    Shindo H, Amino N, Ito Y, Kihara M, Kobayashi K, Miya A, Hirokawa M, Miyauchi A. Papillary thyroid microcarcinoma might progress during pregnancy. Thyroid. 2014;24:840–4.CrossRefGoogle Scholar
  26. 26.
    Ito Y, Miyauchi A, Kudo T, Ota H, Yoshioka K, Oda H, Sasai H, Nakayma A, Yabuta T, Masuoka H, Fukushima M, Higashiyama T, Kihara M, Kobayashi K, Miya A. Effects of pregnancy on papillary microcarcinoma of the thyroid re-evaluated in the entire patient series at Kuma Hospital. Thyroid. 2016;26:156–60.CrossRefGoogle Scholar
  27. 27.
    Oda H, Miyauchi A, Ito Y, Yoshioka K, Nakayama A, Sasai H, Masuoka H, Yabuta T, Fukushima M, Higashiyama T, Kihara M, Kobayashi K, Miya A. Incidence of unfavorable events in the management of low-risk papillary microcarcinoma of the thyroid by active surveillance versus immediate surgery. Thyroid. 2016;26:150–5.CrossRefGoogle Scholar
  28. 28.
    Oda H, Miyauchi A, Ito Y, Sasai H, Masuoka H, Yabuta T, Fukushima M, Higashiyama T, Kihara M, Kobayashi K, Miya A. Comparison of the costs of active surveillance and immediate surgery in the management of low-risk papillary microcarcinoma of the thyroid. Endocr J. 2017;64:59–64.CrossRefGoogle Scholar
  29. 29.
    Miyauchi A, Kudo T, Ito Y, Oda H, Sasai H, Higashiyama T, Fukushima M, Masuoka H, Kihara M, Miya A. Estimation of the lifetime probability of disease progression of papillary microcarcinoma of the thyroid during active surveillance. Surgery. 2018;163:48–52.CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of SurgeryKuma HospitalKobeJapan

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