Incidental Papillary Thyroid Carcinoma: Diagnostic Findings in a Series of 287 Carcinomas
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Incidental Papillary Thyroid Carcinoma: Diagnostic Findings in a Series of 287 Carcinomas Fabio Pagni & Marta Jaconi & Alberto Delitala & Mattia Garancini & Matteo Maternini & Francesca Bono & Alessandro Giani & Andrew Smith & the San Gerardo Hospital collaborators group
# Springer Science+Business Media New York 2014
Abstract The recent increase in the detection of papillary thyroid carcinoma (PTC) has been influenced by the finding of incidental tumours. To this group, carcinomas measuring less than 1 cm (the so-called microcarcinomas) as well as those above 1 cm belong. Analyzing a case series from our own experience, this paper focuses on the current preoperative diagnostic challenges that can lead to PTC incidental discovery. For this retrospective study, 287 patients with a PTC diagnosis were selected. For each, the following variables were analysed: sex, age, ultrasound (US) appearance, number of thyroid nodules, PTC size, PTC variants and presence of other associated pathology. Pre-operative fine needle aspiration (FNA) results were classified according to the fivetiered SIAPEC system. For 281 patients, the US-guided FNA results were available. Cytohistological correlation was evaluated in terms of FNA sensitivity and false negative rate. An incidental PTC was found in 45.2 % of patients. The majority of these were due to unsuccessful US detection of malignant nodules (103 cases); incorrect cytological diagnosis was
responsible for the other 24 cases. The most powerful clinical confounding factors were: multinodular background versus single nodule presentations (p
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