Papillary microcarcinomas of the thyroid gland: do we need to be aggressive in the management?

ABSTRACT

To identify patients with papillary microcarcinomas of the thyroid gland [PMCT] and adopt a policy for their management. Retrospective. Kuwait University Hospital, Sana'a, Yemen. Five hundred and fifty consecutive patients who underwent thyroidectomy. Ultrasound [US] and fine needle aspiration [FNA]. Clinical course of subjects with PMCT. The overall PMCT rate was 9.5% [44 / 465] and female to male ratio was 101. Fine needle aspiration [FNA], performed pre-operatively showed a benign lesion in about 50% of the patient. Subtotal thyroidectomy was performed in 50% patients, while the rest were managed by lobectomy or near total thyroidectomy. PMCT is not uncommon among patients with benign thyroid diseases. The sensitivity of neck ultrasound and FNA in detecting PMCT is rising. The lack of guidelines created a wide range of management policies. We recommend a less aggressive procedure for PMCT of 5 mm and less. A sound policy and guideline in preoperative investigation will assist this approach: