[Papillary microcarcinoma [correction of carcinoma] of the thyroid: clinical experience and prognosis factors].

: Thyroid neoplasm of less than 10 mm in the largest diameter are defined as minimal thyroid cancer (MTC). These tumors are a common incidental finding at autopsy and in thyroid glands excised for other pathology. These tumors can metastasize and can cause significant morbidity and mortality. Clinical significance and optimal operative procedures of these lesions are still questioned. We studied 35 MTC in order to identify clinical and histologic characteristics as prognostic factors and to establish therapeutic management strategies. From January 1988 to December 1998, 177 patients with a primary thyroid cancer underwent surgery in the Department of endocrine-surgery of Catholic University in Rome: 35 of them (19.7%) had a MTC. In the post-operative follow-up 13 of the patients with MTC had a lymph node recurrency and/or distant metastases. Careful histologic examination showed multifocality in 12 patients, capsular infiltration in 10 patients and a solid tumor in 9 patients. MTC are common and they are associated with a good prognosis. Our multifactorial analysis has identified as important risk factors: capsular infiltration, solid lesion and multifocal disease. In these cases total thyroidectomy is mandatory.