Thyroid Papillary Microcarcinoma in Resected Benign Multinodular Goiters Correlates with Specimen Weight
Keywords:
Papillary microcarcinoma thyroid, Multinodular goiter, ThyroidectomyAbstract
Introduction
The thyroid cancer in Pakistan is accountable for 1.2% cases of all cancers. Earlier information from Pakistan showed papillary thyroid carcinoma (PTC) to comprise 57-89% of all thyroid malignancies As per World Health Organization (WHO), papillary microcarcinoma of thyroid (PMCT) is a small area of malignant transformation measuring up to 1 cm or less being defined by WHO, that is currently being diagnosed more often than the past. Albeit small, they have the capability of metastasizing to regional lymph node and may disappear after metastasis.
Objective
To evaluate the prevalence of PMCT in benign multinodular goiter in thyroidectomy specimens.
Materials
The study was performed in Histopathology Laboratory of Peshawar Medical College, where 32 specimens of multinodular goitre (MNG) patients were received from its affiliated hospitals. The patients’ details were obtained from the hospital records. The specimens were closely examined for the presence of suspicious foci both grossly and microscopically. Results obtained were recorded and data was analyzed statistically.
Results
All the 32 specimens of the patients were thyroids. The results show a predominance of female patients in surgically resected MNGs with a relatively low incidence of neoplastic transformation. Our study reported two cases of PMCT and both were from different age groups, one was below 25-years and the other was 48-years. Patients mean age was 38.63-years with a SD±12.95 years. The size and weight of the samples varied. The mean of weight was 206.31±304.50 grams, which is due to the reason that many outliers were noted in weight category.
Conclusion
In thyroid excisions the weight of the excised specimen holds much great importance in determination/diagnosis of the disease. The risk of malignancy is higher in MNG compare to solitary nodules. The prevalence of PMCT (6.25%) are higher in smaller nodules is compare to PTC (3.12%). Furthermore, the fact that our both PMCTs occurred in total thyroidectomy specimens cautions us for their prudent assessment both in gross and histopathological levels.
References
Christoph H. Histological Typing of Thyroid Tumours. Tokyo, Japan: Springer-Verlag Berlin Heidelberg; 2012.
Haltaş H, Bayrak R, Yenidünya S, Yildirim U. Diagnostic value 15 Hadi S et al of cytokeratin 19, HBME-1, and galectin-3 immunostaining of cell block from fine-needle aspiration specimens in papillary carcinoma of the thyroid. Turk J Med Sci. 2013; 43(4): 625-630. doi: 10.3906/ sag-1208-66
Bukhari U, Sadiq S, Kehar SI. Differential expression of CK 19 in follicular adenoma, well-differentiated tumour of uncertain malignant potential (WDT-UMP) and follicular variant of papillary carcinoma. J Pak Med Assoc. 2009; 59(1): 15-18.
Shah SH, Muzaffar S, Soomro IN, Hasan SH. Morphological pattern and frequency of thyroid tumors. J Pak Med Assoc. 1999; 49(6): 131-133.
Mulaudzi T, Ramdial P, Madiba T, Callaghan R. Thyroidcarci-noma at King Edward VIII Hospital, Durban, South Africa. East Afr Med J. 2001; 78(5): 242-245. doi: 10.4314/eamj.v78i5.9046
Clayden EC. Practical Section Cutting and Staining. Edinburgh, Scot-land: Churchill Livingstone; 1971.
Bisi H, Fernandes VS, De Camargo RY, Koch L, Abdo AH, de Brito T. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special ref-erence to the incidental carcinoma. Cancer. 1989; 64(9): 1888-1893. doi: 10.1002/1097-0142(19891101)64:9<1888::aid-cncr2820640922>3.0.co;2-c
Heba GM, Mohamed S, Nevine H, Huda F, Allah K. Outcome and prognostic factors of surgical and radioactive iodine treatment in micropapillary thyroid carcinoma. J Am Sci. 2017; 13(5).
Nori LB, Sam MW. Papillary thyroid microcarcinoma: the sig-nificance of high risk features. BMC Cancer. 2017; 17(1): 142. doi:
1186/s12885-017-3120-0 10. Fink A, Tomlinson G, Freeman JL, Rosen IB, Asa SL. Occult micropapillary carcinoma associated with benign follicular thyroid disease and unrelated thyroid neoplasms. Mod Pathol. 1996; 9(8): 816-820.
Hughes DT, Haymart MR, Miller BS, Gauger PG, Doherty GM. The most commonly occurring papillary thyroid cancer in the United States is now a microcarcinoma in a patient older than 45 years. Thyroid. 2011; 21(3): 231-236. doi: 10.1089/thy.2010.0137
Attaullah S, Haq BS, Muska M. Thyroid dysfunction in khyber pakhtunkhwa, Pakistan. Pak J Med Sci. 2016; 32(1): 111-115. doi: 10.12669/pjms.321.8476
Mcconahey WM, Hay ID, Woolner LB, van Heerden JA, Tay-lor WF. Papillary thyroid cancer treated at the Mayo Clinic, 1946 through 1970: Initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin Proc. 1986; 61(12): 978-996. doi: 10.1016/ s0025-6196(12)62641-x
Karamanakos SN, Markou KB, Panagopoulos K, Karavias D, Vagianos CE, Scopa CD, et al. Complications and risk factors re-lated to the extent of surgery in thyroidectomy. Results from 2,043 procedures. Hormones (Athens). 2010; 9(4): 318-325. doi: 10.14310/ horm.2002.1283
Hay ID, Hutchinson ME, Gonzalez-Losada T, McIver B, Rein-alda ME, Grant CS, et al. Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery. 2008; 144(6): 980-988. doi: 10.1016/j.surg.2008.08.035
Ameet KV, Awati SM. Multi-nodular goiter: Epidemiology, Eti-ology. Pathogenesis and Pathology. 2015; 2(9): 152-156.
Sanjeeva KK, Chandra B, Balakrishna MA, Ramesh DB. Clini-co-epidemiological study and treatment outcome of multinodular goitre at a tertiary care hospital. J Clin Diagn Res. 2015; 9(6): PC22- PC25. doi: 10.7860/JCDR/2015/12947.6098
Shah JP. Thyroid carcinoma: Epidemiology, histology, and diag-nosis. Clin Adv Hematol Oncol. 2015; 13(4 Suppl 4): 3-6.
Harach HR, Franssila KO, Wasenius VM. Occult papil-lary carcinoma of the thyroid. A “normal” finding in Fin-land. A systematic autopsy study. Cancer. 1985; 56(3): 531-538. doi: 10.1002/1097-0142(19850801)56:3<531::aid-cncr2820560321>3.0.co;2-3
Komorowski RA, Hanson GA. Occult thyroid pathology in the young adult: an autopsy study of 138 patients without clinical thyroid disease. Hum Pathol. 1988; 19(6): 689-696. doi: 10.1016/ s0046-8177(88)80175-8 Submit your article to this journal | https://openventio.org/submit-manuscript/ Hadi S et al
Hernandez-Prera JC, Machado RA, Asa SL, Baloch Z, Faquin WC, Ghossein R, et al. Pathologic reporting of tall-cell variant of papillary thyroid cancer: Have we reached a consensus? Thyroid. 2017; 27(12): 1498-1504. doi: 10.1089/thy.2017.0280
Solares CA, Penalonzo MA, Xu M, Orellana E. Occult pap-illary thyroid carcinoma in postmortem species: Prevalence at autopsy. Am J Otolaryngol. 2005; 26(2): 87-90. doi: 10.1016/j.am-joto.2004.08.003
Tanriover O, Comunoglu N, Eren B, Comunoglu C, Turkmen N, Dogan M, et al. Occult papillary thyroid carcinoma: prevalence at autopsy in Turkish people. Eur J Cancer Prev. 2011; 20(4): 308- 312. doi: 10.1097/CEJ.0b013e32834473dc
Zambudio AR, Rodríguez J, Riquelme J, Soria T, Canteras M, Parrilla P. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with ex-perience in endocrine surgery. Ann Surg. 2004; 240(1): 18-25. doi: 10.1097/01.sla.0000129357.58265.3c
Hopwood D. Fixation and fixatives. In: Bancroft J, Stevens A, eds. Theory and Practice of Histological Techniques. New York, USA: Churchill Livingstone; 1996.
Carson FL. Histotechnology. 2nd ed. Chicago, USA: ASCP Press; 2007.
Winsor L. Tissue processing. In Woods A, Ellis R, eds. Labora-tory Histopathology. New York, USA: Churchill Livingstone; 1994; 4. 2-1-4. 2-39.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Pathology and Laboratory Medicine (PLM) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
