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11.10.2019 | Original Scientific Report

Surgical Management of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma. Experience in 25 Patients

verfasst von: Claudio Spinelli, Silvia Strambi, Sohail Bakkar, Andrea Nosiglia, GianMarco Elia, Alessia Bertocchini, Chiara Calani, Matteo Leoni, Riccardo Morganti, Gabriele Materazzi

Erschienen in: World Journal of Surgery

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Abstract

Purpose

To delineate the clinicopathologic features and biologic behavior of the diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) and to report its outcome.

Methods

The clinical records of 25 patients who had surgery for DSV-PTC from 2004 to 2017 were retrospectively analyzed. Comparisons were made to similar studies in the literature reporting ≥8 cases and a cohort of classical PTC.

Results

There were 20 females and 5 males with an average age of 23 years (range 10–39 years). Bilateral disease occurred in 80% of cases. The mean size of the dominant mass was 4.2 ± 1.92 cm. In 92% of cases, therapeutic neck dissection was performed. Male sex significantly correlated with a higher yield of positive lymphadenopathy (p = 0.045). 62% of patients had recurrent disease. Recurrence significantly correlated with male sex, the number of metastatic lymph nodes (cutoff: 22 lymph nodes), and multifocality (p = 0.044, p ˂ 0.008, p ˂ 0.003, respectively). However, it did not correlate with the age at presentation. No disease-specific mortality occurred after an average follow-up of 77 months (range 12–168 months). The two comparisons made demonstrated a statistically significant greater tendency of the current series of DSV-PTC toward more aggressive clinicopathologic features and biologic behavior. No differences in overall survival were observed.

Conclusion

The DSV-PTC should be considered a high-risk PTC that mandates an aggressive therapeutic strategy with the intent of optimizing disease-free survival.
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Metadaten
Titel
Surgical Management of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma. Experience in 25 Patients
verfasst von
Claudio Spinelli
Silvia Strambi
Sohail Bakkar
Andrea Nosiglia
GianMarco Elia
Alessia Bertocchini
Chiara Calani
Matteo Leoni
Riccardo Morganti
Gabriele Materazzi
Publikationsdatum
11.10.2019
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05230-5

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