Incidentally discovered papillary thyroid microcarcinoma in patients undergoing thyroid surgery for benign disease

• Published in: Endocrine Vol. 77; no. 2; pp. 325 - 332
• Main Authors: de Carlos, Joaquín, Ernaga, Ander, Irigaray, Ana, Pineda, Jose Javier, Echegoyen, Ana, Salvador, Pilar, Anda, Emma
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2022; Springer Nature B.V
• Subjects: Age; Benign; Diabetes; Endocrinology; Goiter; Graves disease; Humanities and Social Sciences; Hyperplasia; Internal Medicine; Malignancy; Medicine; Medicine & Public Health; multidisciplinary; Original Article; Pathology; Patients; Science; Statistical analysis; Surgery; Thyroid carcinoma; Thyroid gland; Thyroidectomy; Thyroiditis; Thyroid surgery; Benign thyroid disease; Papillary thyroid microcarcinoma; Incidental
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-022-03089-6

Introduction The incidence of thyroid carcinoma has grown significantly over the last few decades. A possible explanation is the increased diagnosis of small thyroid microcarcinoma (TMc). TMc reach a maximum diameter of ≤1 cm, identified during histopathology examination following a thyroidectomy performed for reasons not pertaining to malignancy. This study aims to investigate the prevalence of papillary thyroid microcarcinoma (PTMc) according to the benign pathology that refers patients to surgery and its trend evolution. Methods Retrospective cohort analysis of 1815 patients who underwent total thyroidectomy for non-malignant diseases in the 2005–2020 period. Results The mean age of the subjects was 53.5 years, with a higher proportion of women (1481, 82.1%). A total of 167 PTMc (9.3%) were incidentally discovered. A multivariate logistic regression analysis was performed, showing no differences in prevalence according to sex or age in patients with PTMc compared to final benign histology. Multinodular goiter increases the risk of PTMc with an odds ratio of 2.2 ( p  = 0.001) compared to Hashimoto’s thyroiditis and Graves’ disease (GD). There is a statistically significant increase in the incidence of PTMc in the group operated in the 2017–2020 vs. 2005–2008 period ( p  = 0.005). Conclusion The overall prevalence of PTMc in patients who underwent thyroid surgery for the benign disease was 9.3%. Thyroid nodular hyperplasia was the most frequent benign pathology associated with PTMc compared to Hashimoto’s or GD. Gender and age were not correlated with the prevalence of TMc. Over the years, surgical findings of PTMc have grown, particularly in the 2017–2020 period.