epidemic of papillary thyroid microcarcinoma: an overview

According to the World Health Organization, papillary thyroid microcarcinoma [PTmC] is a papillary thyroid cancer [PTC] measuring 10 mm or less in size. There has been a recent worldwide increase in the incidence of thyroid cancer, largely attributed to an increase in the incidence of PTC and more precisely to an increase in the incidence of PTmC. The management of PTmC continues to be an area of controversy and has resulted in wide differences in recommended management, ranging from observation to an aggressive approach with total thyroidectomy, central lymph node dissection and radioiodine ablation therapy. The aim of this review is to present some of the recently published studies discussing the clinical aspects of this disease [PTmC]

Surgical management of retrosternal goiter: local experience at a university hospital

Retrosternal goiter [RSG] is a term that has been used to describe a goiter that extends beyond the thoracic inlet. Surgery plays an important role in the treatment of these patients, but whether all or selected patients with RSG should undergo this operation remains controversial. Our aim is to look into the demographics, presentation, and treatment of patients with RSG and essentially to determine the role of surgery in its treatment. Retrospective study, teaching hospital-based. Retrospective analysis of 537 thyroidectomies performed at King Khalid University Hospital between 2003 and 2010. The twenty-six patients with RSG were analyzed further, with regard to demographics, presentation, indications, and outcome of surgical treatment. Statistical analysis was performed, where age was expressed as mean and range, and other variables were presented as numbers and percentage. There were 26 patients [4.8%] with RSG out of 537 thyroidectomies, who underwent an operation for removal of RSGs, in a seven-year period. The most common presentation was dyspnea [34.6%] and the surgical procedure predominantly used was total thyroidectomy. The RSGs were removed by collar incision in 96% of the cases. The final histological diagnosis revealed malignancy in 26.9% of the thyroid specimens. There was no mortality and minor complications occurred in nine patients. The presence of an RSG is an indication for surgery owing to the lack of effective medical treatment, the higher incidence of symptoms related to compression, low surgical morbidity, and the risk of malignancy