Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro Traslacional de Endocrinología UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-7129-9543.
Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-7449-7035.
Medwave. 2021 Nov 29;21(10):e8493. doi: 10.5867/medwave.2021.10.8493.
Papillary thyroid cancer is the most common endocrine malignancy, and due to its favorable prognosis, the extent of surgery has been a matter of debate. About 10% of these tumors are located in the thyroid isthmus, with no specific management in current guidelines. In the last decades, isthmusectomy has been proposed as a therapeutic option for isthmic papillary thyroid carcinoma, although there is no consensus on its management. We present two cases of patients from our institution with solitary isthmic papillary thyroid carcinoma without clinical macroscopic extrathyroidal extension or clinical-radiological lymph node involvement who were treated with isthmusectomy without prophylactic lymph node dissection. Neither of them had any postoperative complications. Both had an intermediate risk of recurrence due to aggressive variants. None of them had signs of recurrence during follow-up. We intend to show that isthmusectomy seems to be an effective and safe surgical alternative in selected patients through these cases.
甲状腺乳头状癌是最常见的内分泌恶性肿瘤，由于其预后良好，手术范围一直存在争议。大约 10%的此类肿瘤位于甲状腺峡部，目前的指南中没有针对其的特定处理方法。在过去的几十年中，峡部切除术已被提议作为治疗峡部甲状腺乳头状癌的一种选择，尽管其管理尚无共识。我们介绍了来自我们机构的两名患者的病例，他们患有孤立性峡部甲状腺乳头状癌，没有临床肉眼甲状腺外扩展或临床-影像学淋巴结受累，他们接受了峡部切除术而没有预防性淋巴结清扫术。他们两人都没有术后并发症。由于侵袭性变异，两人的复发风险均为中度。在随访期间，他们均无复发迹象。我们旨在通过这些病例表明，峡部切除术似乎是一种有效的、安全的手术选择，适用于特定患者。
