Familial papillary thyroid microcarcinoma: a new clinical entity

Lancet. 1999 Feb 20;353(9153):637-9. doi: 10.1016/S0140-6736(98)08004-0.

Abstract

Background: Familial, non-medullary thyroid carcinoma is clinically more aggressive than the sporadic form. We wanted to find out whether papillary thyroid microcarcinoma also occurs in a familial pattern, and, if so, to identify specific clinical and prognostic features.

Methods: We reviewed the clinical records of 119 patients with papillary thyroid microcarcinoma. Familial occurrence, together with clinical presentation, surgical treatment, pathological characteristics, and follow-up were recorded.

Findings: We identified a family history of thyroid carcinoma in seven patients. The tumour was multifocal in five patients, bilateral in three, and vascular invasion occurred in three of the seven patients. Lymph-node metastases were found in four patients. Three patients had a recurrence and one patient with pulmonary metastases died within 11 months.

Interpretation: We identified familial occurrence in 5.9% of cases of papillary thyroid microcarcinoma. The unfavourable behaviour in the familial form of papillary thyroid microcarcinoma suggests that radical treatment and careful follow-up are warranted.

MeSH terms

  • Adult
  • Carcinoma, Papillary / genetics*
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / radiotherapy
  • Carcinoma, Papillary / secondary
  • Carcinoma, Papillary / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary
  • Lymph Node Excision
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Survival Rate
  • Thyroid Neoplasms / genetics*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / radiotherapy
  • Thyroid Neoplasms / surgery
  • Thyroidectomy