Clinical Characteristics of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma

Received April 2, 2013 Revised August 2, 2013 Accepted August 22, 2013 Address for correspondence Ik Joon Choi, MD Department of OtolaryngologyHead and Neck Surgery, Korea Cancer Center Hospital, 75 Nowon-ro, Nowon-gu, Seoul 139-706, Korea Tel +82-2-970-2173 Fax +82-2-970-2450 E-mail medica95@hanmail.net Background and ObjectivesZZDiffuse sclerosing variant (DSV) is a rare variant of papillary thyroid carcinoma (PTC) and has been adopted as a histologic variant. Due to the limited number of cases and the heterogeneity of the tumor’s clinical behavior, there is no consensus for DSV’s optimal treatment and post-operative follow-up. The purpose of this study is to evaluate the clinical manifestation, recurrence and prognosis of 10 patients with DSV. Subjects and MethodZZWe retrospectively reviewed ten consecutive patients in whom DSV was first observed between 2000 and 2012. All patients are presently under active follow-up at Korea Cancer Center Hospital. Patients underwent a total thyroidectomy with central compartment and laterocervical lymph node dissection only when this involvement was documented by pre-surgery ultrasound examination with fine needle aspiration biopsy. ResultsZZThe mean observation interval was 41.6 months. The ratio of male to female was 1 : 9, and the age of incidence was 34.2±11.4. The average size of mass was measured 2.9±1.9 cm. Upon the diagnosis, eight cases had central and lateral neck lymph nodal metastasis, which was confirmed during the operation. There was no distant metastasis, but one case was confirmed with lung metastasis during the follow-up period. There was no mortality during the follow-up periods in all ten cases. ConclusionZZDSV of PTC has high risk characteristics of large tumor size, extrathyroidal extension, and multiple lymph nodes metastasis. We may expect comparable outcome with classical PTC by proper surgical treatment and postoperative radioactiveiodine ablation. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:711-6