Ardito G, Revelli L, Lucci C, Giacinto O, Praquin B
Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, Roma.
Ann Ital Chir. 2001 May-Jun;72(3):261-5.
Thyroid neoplasm of less than 10 mm in the largest diameter are defined as minimal thyroid cancer (MTC). These tumors are a common incidental finding at autopsy and in thyroid glands excised for other pathology. These tumors can metastasize and can cause significant morbidity and mortality. Clinical significance and optimal operative procedures of these lesions are still questioned. We studied 35 MTC in order to identify clinical and histologic characteristics as prognostic factors and to establish therapeutic management strategies. From January 1988 to December 1998, 177 patients with a primary thyroid cancer underwent surgery in the Department of endocrine-surgery of Catholic University in Rome: 35 of them (19.7%) had a MTC. In the post-operative follow-up 13 of the patients with MTC had a lymph node recurrency and/or distant metastases. Careful histologic examination showed multifocality in 12 patients, capsular infiltration in 10 patients and a solid tumor in 9 patients. MTC are common and they are associated with a good prognosis. Our multifactorial analysis has identified as important risk factors: capsular infiltration, solid lesion and multifocal disease. In these cases total thyroidectomy is mandatory.
最大直径小于10毫米的甲状腺肿瘤被定义为微小甲状腺癌（MTC）。这些肿瘤在尸检以及因其他病理情况而切除的甲状腺中是常见的偶然发现。这些肿瘤可发生转移，并可导致严重的发病率和死亡率。这些病变的临床意义和最佳手术方法仍存在疑问。我们研究了35例微小甲状腺癌，以确定作为预后因素的临床和组织学特征，并制定治疗管理策略。1988年1月至1998年12月，177例原发性甲状腺癌患者在罗马天主教大学内分泌外科接受了手术：其中35例（19.7%）患有微小甲状腺癌。在术后随访中，13例微小甲状腺癌患者出现淋巴结复发和/或远处转移。仔细的组织学检查显示，12例患者有多灶性，10例患者有包膜浸润，9例患者有实体瘤。微小甲状腺癌很常见，且预后良好。我们的多因素分析确定了重要的危险因素：包膜浸润、实体病变和多灶性疾病。在这些情况下，全甲状腺切除术是必要的。
