The Implications of Micro-Papillary Thyroid Carcinoma in Surgical Treatment of Multi-nodular Goiter

Authors

  • Hussain Taher Abbas AL-baaj

Keywords:

micro-papillary carcinoma, multi-nodular goiter, hashomotos disease

Abstract

Background: papillary thyroid micro-carcinoma(PTMC) is defined as papillary thyroid carcinoma less than 10mm in diameter, it is common pathology and form one third of PTC, its management is debatable due to its aggressive behavior in some cases. its diagnosis are done incidentally in most of cases but recent ultrasound with FNCA increase the incidence of diagnosis.

Patients and methods: The Study is conducted on 147 cases of papillary thyroid carcinoma(PTC) that operated upon between 2018-2022 for goiter randomly. The type of surgery is either lobectomy, total thyroidectomy or partial thyroidectomy. The pathologist decrease the thyroid lesion to less than few mm in diameter instead of more than 10 mm that done previously. the cases are divided into 3 group: group A include micro-carcinoma , group B include malignant nodule more than 1 cm in multi-nodular goiter(MNG) and group C that include single papillary  nodule.

Result: of 149 cases with PTC, 47 cases are PTMC (group  A), 27 cases are in group B that include PTC more than  one centimeter in diameter and group C that present with solitary malignant nodules that include 75 cases. Of 47 cases with PTMC, 27 cases contain malignant foci between 1-3 mm while in 11 cases , the size between 4-5 mm and 9 cases with diameter between 6 to 9 mm .Thirty–nine of PTMC cases are seen in MNG, 7 cases in Hashomoto s thyroiditis and one case in graves disease.

Ten of 16 cases of colloid MNG are between, the size of malignant nodule are in range of  1-1.5 cm. seven of 11 cases of PTC in Hashomoto s are multifocal.

Conclusion: PTMC is common pathology, mainly seen in MNG, and in most of the cases, they are small in size 3mm or less in diameter and difficult to recognize by ultrasound so adoption of total lobectomy or total thyroidectomy instead of partial thyroidectomy ensure complete excision of this pathology which may have unexpected behavior in some cases. PTC(more than 1 cm) on background of MNG, mainly are of small size and present in non-dominant  nodule.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Ito Y, Miyauchi A, Oda H. Low risk papillary micro-carcinoma of thyroid: a review of active surveillance trials. Rur J Surg Onco. 2018;44(3):1-133.

Zhao Q, Ming J , Liu C, et al. multifocality and total tumor diameter predict central neck lymph node metastases in PTMC. Ann Surgery Oncol. 2013;20:746-52.

Lin, JD. Increased Incidence of Papillary thyroid micro-carcinoma with decreased tumor size of thyroid cancer.Med Oncol 27,510-518(2010).

Krzysztof K. et al. Comparison of the prevalence of incidental and non-incidental PTMC during 2008-2016: a single center experience. World Journal of Surgical oncology 16, Article number :202(2018).

Yasuhiro Ito, et al. Patient Age Is Significant Related to the Progression of Papillary Micro-carcinoma of the Thyroid Under Observation.2014 Jan 1 ;24(1):27-34.

Kaliszewski K , at el. Incidental and non-incidental thyroid micro-carcinoma. Oncol Lett. 2016:12:734-40.

Shiva D, et al. thyroid papillary microcrcinoma :Etiology, Clinical Manifestations, Diagnosis , Follow up, Histopathology and Prgnosis.Iran J Pathol. 2016 Winter;11(1):1-19

Aldo B.et al,incidence and clinical relvence of Incidental Papillary Carcinoma in Thyroidectomy forming.J. Clin, Med. 2023, 12(8),2770.

JS Yong et al. multinodular goiter: A study of malignancy risk in nondominant nodules. ENT-Ear, nose and Throat Journal. August 2017:334-337.

Goldust M et al.A Clinical epidemologlogical study of thyroid carcinomain patients under 25 years old in Tabriz. Iran(1995-2010)JPMA. 2012:62:1265.

Cvejic D et al.Apoptosis and proliferationrelated molecules(Bcl-2, Bax, p53,PCNA) IN papillary microcarcinomaversus papillary carcinoma of the thyroid.. Pathology 2008 ;40:475-80.

Neuhold N, etal.incidental papillary microcarcinoma of the thyroid-further evidence of very low malignant potential: retrospective clinicopathologogical study with up 30 years of follow up. Ann Surg Oncol. 2011;18 :3430-6 .

Arif, A., Alameri, A. A., Tariq, U. B., Ansari, S. A., Sakr, H. I., Qasim, M. T., ... & Karampoor, S. (2023). The functions and molecular mechanisms of Tribbles homolog 3 (TRIB3) implicated in the pathophysiology of cancer. International Immunopharmacology, 114, 109581.

Lafta, H. A., AbdulHussein, A. H., Al-Shalah, S. A., Alnassar, Y. S., Mohammed, N. M., Akram, S. M., ... & Najafi, M. (2023). Tumor-associated macrophages (TAMs) in cancer resistance; modulation by natural products. Current topics in medicinal chemistry, 23(12), 1104-1122.

Qasim, M. T., Fenjan, M. N., & Thijail, H. A. (2022). Molecular identification of cystoisospora belli in patients infected with the virus human immunodeficiency. International Journal of Drug Delivery Technology, 12(2), 701-704.

Margiana, R., Alsaikhan, F., Al-Awsi, G. R. L., Patra, I., Sivaraman, R., Fadhil, A. A., ... & Hosseini-Fard, S. (2022). Functions and therapeutic interventions of non-coding RNAs associated with TLR signaling pathway in atherosclerosis. Cellular Signalling, 100, 110471.‏

Arif, A., Alameri, A. A., Tariq, U. B., Ansari, S. A., Sakr, H. I., Qasim, M. T., ... & Karampoor, S. (2023). The functions and molecular mechanisms of Tribbles homolog 3 (TRIB3) implicated in the pathophysiology of cancer. International Immunopharmacology, 114, 109581.‏

Lei, Z., Alwan, M., Alamir, H. T. A., Alkaaby, H. H. C., Farhan, S. S., Awadh, S. A., ... & Nekuei, A. (2022). Detection of abemaciclib, an anti-breast cancer agent, using a new electrochemical DNA biosensor. Frontiers in Chemistry, 10, 980162.‏

Bashar, B. S., Kareem, H. A., Hasan, Y. M., Ahmad, N., Alshehri, A. M., Al-Majdi, K., ... & Qasim, M. T. (2022). Application of novel Fe3O4/Zn-metal organic framework magnetic nanostructures as an antimicrobial agent and magnetic nanocatalyst in the synthesis of heterocyclic compounds. Frontiers in Chemistry, 10, 1014731.‏

Patel, A. A., Asma'a, H. M., Rizaev, J., Mallick, A. K., Qasim, M. T., Al Abdulmonem, W., ... & Ahmad, F. (2024). Application of mesenchymal stem cells derived from the umbilical cord or Wharton’s jelly and their extracellular vesicles in the treatment of various diseases. Tissue and Cell, 102415.

Qasim, M. T., Mahdi Mohammed Alakkam, E., Mahdi Mohammed, M., Hachim, S. K., Sabah Jabr, H., Emad Izzat, S., ... & D Al-Dhalemi, M. (2022). Ovine Pasteurellosis Vaccine: Assessment of the Protective Antibody Titer and Recognition of the Prevailing Serotypes. Archives of Razi Institute, 77(3), 1207-1210.

Hjazi, A., Ahsan, M., Alghamdi, M. I., Kareem, A. K., Al-Saidi, D. N., Qasim, M. T., ... & Mirzaei, R. (2023). Unraveling the Impact of 27-Hydroxycholesterol in Autoimmune Diseases: Exploring Promising Therapeutic Approaches. Pathology-Research and Practice, 154737.‏

Hjazi, A., Nasir, F., Noor, R., Alsalamy, A., Zabibah, R. S., Romero-Parra, R. M., ... & Akram, S. V. (2023). The pathological role of CXC chemokine receptor type 4 (CXCR4) in colorectal cancer (CRC) progression; special focus on molecular mechanisms and possible therapeutics. Pathology-Research and Practice, 154616.‏

Gupta, J., Suliman, M., Ali, R., Margiana, R., Hjazi, A., Alsaab, H. O., ... & Ahmed, M. (2023). Double-edged sword role of miRNA-633 and miRNA-181 in human cancers. Pathology-Research and Practice, 154701.‏

Sane, S., Mahoori, A., Abdulabbas, H. S., Alshahrani, S. H., Qasim, M. T., Abosaooda, M., ... & Darvishzadehdaledari, S. (2023). Investigating the effect of pregabalin on postoperative pain in non-emergency craniotomy. Clinical Neurology and Neurosurgery, 226, 107599.

Al-dolaimy, F., Kzar, M.H., Hussein, S.A. et al. (2023). Incorporating of Cobalt into UiO-67 Metal–Organic Framework for Catalysis CO2 Transformations: An Efficient Bi-functional Approach for CO2 Insertion and Photocatalytic Reduction. J Inorg Organomet Polym. https://doi.org/10.1007/s10904-023-02860-0

Muzammil, K., Kzar, M. H., Mohammed, F., Mohammed, Z. I., Hamood, S. A., Hussein, T. K., ... & Alsalamy, A. (2023). Methanol extract of Iraqi Kurdistan Region Daphne mucronata as a potent source of antioxidant, antimicrobial, and anticancer agents for the synthesis of novel and bioactive polyvinylpyrrolidone nanofibers. Frontiers in Chemistry, 11, 1287870.

Al-Safi, M. T., & Qasim, M. T. (2023). Study of some genetic and molecular markers for some rheumatoid arthritis patients in Iraq.‏.‎

Ramaiah, P., Baljon, K. J., Hjazi, A., Qasim, M. T., Salih Al-ani, O. A., Imad, S., ... & Garousi, N. (2024). Dietary polyphenols and the risk of metabolic syndrome: a systematic review and meta-analysis. BMC Endocrine Disorders, 24(1), 26.

Hsu, C. Y., Ahmed, A. T., Bansal, P., Hjazi, A., Al-Hetty, H. R. A. K., Qasim, M. T., ... & Elawady, A. (2024). MicroRNA-enriched exosome as dazzling dancer between cancer and immune cells. Journal of Physiology and Biochemistry, 1-19.

Farhan, S. H., Jasim, S. A., Bansal, P., Kaur, H., Abed Jawad, M., Qasim, M. T., ... & Hadi, A. (2024). Exosomal Non-coding RNA Derived from Mesenchymal Stem Cells (MSCs) in Autoimmune Diseases Progression and Therapy; an Updated Review. Cell Biochemistry and Biophysics, 1-18.

Kumar, P., Singh, S., Gacem, A., Yadav, K. K., Bhutto, J. K., Alreshidi, M. A., ... & Alam, M. W. (2024). A review on e-waste contamination, toxicity, and sustainable clean-up approaches for its management. Toxicology, 153904.

Ul Hassan Shah, Z., Bashir, S., Sarfraz, R. M., Mahmood, A., Rehman, U., Ijaz, H., ... & Benguerba, Y. (2024). Development of antihyperlipidemic drug loaded β-CD-based microparticulate carrier systems: tuning and optimization. Polymer-Plastics Technology and Materials, 63(11), 1438-1463.

Hsu, C. Y., Jasim, S. A., Pallathadka, H., Kumar, A., Konnova, K., Qasim, M. T., ... & Abosaoda, M. K. (2024). A comprehensive insight into the contribution of epigenetics in male infertility; focusing on immunological modifications. Journal of Reproductive Immunology, 104274.

Zamanian, M. Y., Shahbazi, T., AL-Ghamdi, H. S., Hussien, B. M., Alghamdi, M. A., Qasim, M. T., ... & Golmohammadi, M. (2024). Chemopreventive and Anticancer Role of Resveratrol against non-melanoma skin cancer (NMSC): Focusing on cellular and molecular mechanisms and biochemistry. Authorea Preprints.

Hjazi, A., Jasim, S. A., Al-Dhalimy, A. M. B., Bansal, P., Kaur, H., Qasim, M. T., ... & Zwamel, A. H. (2024). HOXA9 versus HOXB9; particular focus on their controversial role in tumor pathogenesis. Journal of Applied Genetics, 1-20.

..

Downloads

Published

2025-04-23

How to Cite

1.
Abbas AL-baaj HT. The Implications of Micro-Papillary Thyroid Carcinoma in Surgical Treatment of Multi-nodular Goiter. J Neonatal Surg [Internet]. 2025Apr.23 [cited 2025Jul.17];14(17S):1-6. Available from: https://jneonatalsurg.com/index.php/jns/article/view/4412