Nathalie Chereau1, Tristan Greilsamer2, Eric Mirallié2, Samira M Sadowski3, Marc Pusztaszeri3, Frederic Triponez3, Grégory Baud4, Francois Pattou4, Niki Christou5, Muriel Mathonnet5, Laurent Brunaud6, Nicolas Santucci7, Pierre Goudet7, Carole Guérin8, Frédéric Sebag8, Gianluca Donatini9, Jean-Louis Kraimps9, Frédérique Tissier10, Charlotte Lussey-Lepoutre11, Laurence Leenhardt12, Fabrice Menegaux13. 1. Sorbonne Université, Pitié Salpêtrière Hospital, Paris, France. Electronic address: nathalie.chereau@aphp.fr. 2. Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des maladies de l'Appareil Digestif (IMAD), Hôtel Dieu, CHU Nantes, France. 3. University Hospital of Geneva and Faculty of Medicine of Geneva, Geneva, Switzerland. 4. Claude Huriez University Hospital, Lille, France. 5. University Hospital of Limoges, France. 6. University of Lorraine, Brabois Hospital, Vandoeuvre-les-Nancy, France. 7. University Hospital of Dijon, France. 8. University of Aix Marseille, La Conception Hospital, France. 9. University of Poitiers, Jean Bernard Hospital, France. 10. Sorbonne Université, Department of Pathology,Pitié-Salpêtrière Hospital, Paris, France. 11. Sorbonne Université, Department of Nuclear medicine, Pitié-Salpêtrière Hospital, Paris, France. 12. Sorbonne Université, Thyroid and Endocrine Tumors Unit, Pitié-Salpètrière Hospital, Paris, France. 13. Sorbonne Université, Pitié Salpêtrière Hospital, Paris, France.
Abstract
BACKGROUND: Encapsulated follicular variant of papillary thyroid carcinoma has recently been reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features on the basis of its highly indolent behavior, as proposed by an international group of experienced thyroid pathologists. METHODS: All patients from 9 high-volume endocrine surgery departments who underwent surgery between 2005 and 2015 and whose final surgical pathology revealed noninvasive follicular thyroid neoplasm with papillary-like nuclear features (>10 mm) were included in this study. The primary outcome was to determine the potential for recurrent disease in these patients. RESULTS: Among the 363 patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features, 76% were female with a median age of 50 years (5-86 years); 345 patients (95%) underwent total thyroidectomy. A total of 65 patients had an associated micropapillary thyroid carcinoma. In the group of 133 patients who underwent prophylactic lymph node dissection (37%), 1 patient had a micrometastasis but with an associated micropapillary thyroid carcinoma. Over a median follow-up period of 5 years, 1 patient with an associated micropapillary thyroid carcinoma had recurrent disease at 6 years. All patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features without micropapillary thyroid carcinoma had no lymph node metastasis or recurrent disease. CONCLUSION: We found that noninvasive follicular thyroid neoplasm with papillary-like nuclear features presents with indolent behavior. However, the identification of an associated micropapillary thyroid carcinoma should be carefully evaluated because it could be a factor for lymph node metastasis and/or of recurrence.
BACKGROUND: Encapsulated follicular variant of papillary thyroid carcinoma has recently been reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features on the basis of its highly indolent behavior, as proposed by an international group of experienced thyroid pathologists. METHODS: All patients from 9 high-volume endocrine surgery departments who underwent surgery between 2005 and 2015 and whose final surgical pathology revealed noninvasive follicular thyroid neoplasm with papillary-like nuclear features (>10 mm) were included in this study. The primary outcome was to determine the potential for recurrent disease in these patients. RESULTS: Among the 363 patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features, 76% were female with a median age of 50 years (5-86 years); 345 patients (95%) underwent total thyroidectomy. A total of 65 patients had an associated micropapillary thyroid carcinoma. In the group of 133 patients who underwent prophylactic lymph node dissection (37%), 1 patient had a micrometastasis but with an associated micropapillary thyroid carcinoma. Over a median follow-up period of 5 years, 1 patient with an associated micropapillary thyroid carcinoma had recurrent disease at 6 years. All patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features without micropapillary thyroid carcinoma had no lymph node metastasis or recurrent disease. CONCLUSION: We found that noninvasive follicular thyroid neoplasm with papillary-like nuclear features presents with indolent behavior. However, the identification of an associated micropapillary thyroid carcinoma should be carefully evaluated because it could be a factor for lymph node metastasis and/or of recurrence.