Clinical characteristics of papillary thyroid carcinoma arising from the pyramidal lobe

Sang Gab Yoon; Jin Wook Yi; Chan-Yong Seong; Jong-Kyu Kim; Su-Jin Kim; Young Jun Chai; June Young Choi; Kyu Eun Lee

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자료유형: 학술저널

저자정보: Sang Gab Yoon (Seoul National University College of Medicine) Jin Wook Yi (Seoul National University College of Medicine) Chan-Yong Seong (Seoul National University College of Medicine) Jong-Kyu Kim (Seoul National University College of Medicine) Su-Jin Kim (Seoul National University College of Medicine) Young Jun Chai (Seoul National University College of Medicine) June Young Choi (Seoul National University College of Medicine) Kyu Eun Lee (Seoul National University College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.92 No.3

발행연도: 2017.3

수록면: 123 - 128 (6page)

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Purpose: Papillary thyroid carcinoma (PTC) arising from the pyramidal lobe is rare; therefore, clinicopathologic evaluation is lacking. In addition, the rate of occult malignancy in the pyramidal lobe after thyroid surgery is unclear. This study is to evaluate the clinical characteristics of PTCs that involve the pyramidal lobe.
Methods: The study enrolled 1,107 patients who underwent thyroid surgery for PTC at Seoul National University Hospital from 2006 to 2015. Pyramidal lobe status in pathologic reports was clear in all cases. “Pyramidal lobe-dominant PTC” was defined as single pyramidal lobe cancer or multifocal cancer with larger pyramidal lobe tumor. “Incidental pyramidal lobe PTC” was defined as occult cancer identified after thyroidectomy or as multifocal cancer with smaller pyramidal lobe tumor.
Results: Ten patients were included in the pyramidal lobe-dominant PTC group. The mean age was 58 ± 12.5 years, and the mean tumor size was 0.7 ± 0.7 cm. Cervical lymph node metastasis was found in 5 patients (50%). Three patients had microscopic lymphatic invasion, and 7 had advanced American Joint Comitee on Cancer (AJCC) stage disease (5 with stage III and 2 with stage IV). Compared with conventional PTC (n = 1,058), pyramidal lobe-dominant PTC was significantly associated with lymphatic invasion (P = 0.031) and advanced AJCC stage (P = 0.022). The prevalence of incidental pyramidal lobe PTC was 3.56%.
Conclusion: Pyramidal lobe PTC is relatively small in size; however, the rate of extrathyroidal extension and lymph node metastasis is high. Preoperative evaluation of nodal status is important, and the extent of surgery should be determined in accordance with the preoperative diagnosis.

#Thyroid #Pyramidal #Papillary thyroid carcinoma #Lymphatic metastasis #Thyroid neoplasms

참고문헌 (26)

참고문헌 신청

[학술지(정기간행물)] - Milojevic B / 2013 / Pyramidal lobe of the human thyroid gland: an anatomical study with clinical implications / Rom J Morphol Embryol 54 : 285 ~ 289

[학술지(정기간행물)] - Braun EM / 2007 / The pyramidal lobe: clinical anatomy and its importance in thyroid surgery / Surg Radiol Anat 29 : 21 ~ 27

[학술지(정기간행물)] - Geraci G / 2008 / The importance of pyramidal lobe in thyroid surgery / G Chir 29 : 479 ~ 482

[학술지(정기간행물)] - Ogawa C / 2009 / Follicular carcinoma arising from the pyramidal lobe of the thyroid / J Nippon Med Sch 76 : 169 ~ 172

[학술지(정기간행물)] - Lee YS / 2011 / Recurrence of papillary thyroid carcinoma in a remnant pyramidal lobe / ANZ J Surg 81 : 304 ~

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