Palermo S, Di Matteo F M, Savino G, Di Marco C, Catania A, De Antoni E
Dipartimento di Scienze Chirurgiche, Sapienza Universitá di Roma, Italy.
G Chir. 2010 Jun-Jul;31(6-7):299-302.
Medullary microcarcinomas occurrence are rare and fortuitous, it's usually related to the calcitonin measurement, that's the gold standard for the diagnosis. In other cases performing a thyroidectomy for a benign thyroid disease it's found a sub-centimeter tumor. Actually it's not clear the most appropriate surgical treatment for those kind of tumors because the number of cases in literature is limited and because there are different surgical approaches. In this study 17 patients were operated for medullary thyroid microcarcinoma and the Authors found central lymph node metastases in 33.3% of cases. The Authors, analyzing those results, think that total thyroidectomy with lymphadenectomy of the central compartement is the best choice in a sporadic microcarcinoma, while a total thyroidectomy without lymphadenectomy should be performed when the microcarcinomas are incidentals.
髓样微小癌的发生罕见且偶然，通常与降钙素检测有关，而降钙素检测是诊断的金标准。在其他情况下，因良性甲状腺疾病行甲状腺切除术时发现了小于1厘米的肿瘤。实际上，对于这类肿瘤最合适的手术治疗方法尚不清楚，因为文献中的病例数量有限，且存在不同的手术方式。在本研究中，17例患者接受了甲状腺髓样微小癌手术，作者发现33.3%的病例存在中央区淋巴结转移。作者分析这些结果后认为，对于散发性微小癌，全甲状腺切除加中央区淋巴结清扫是最佳选择，而对于偶然发现的微小癌，则应行全甲状腺切除而不进行淋巴结清扫。
