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Clinical Challenges in Otolaryngology
April 2001

Papillary Carcinoma of the ThyroidExtent of Thyroidectomy

Author Affiliations
 

KAREN H.CALHOUNMD

 

RONALD B.KUPPERSMITHMD

Arch Otolaryngol Head Neck Surg. 2001;127(4):462-463. doi:10.1001/archotol.127.4.462

Dr Otto et al have written a comprehensive review of the salient treatment concerns and objectives in patients with small papillary carcinomas. There are several terms relating to papillary cancer size that have been used with confusion in the literature. Intrathyroid papillary carcinoma refers to disease completely confined within the thyroid gland and does not imply any specific size. "Occult" papillary carcinomas are typically defined as less than 1.5 cm in diameter and are found incidentally at autopsy or in surgical specimens, but were not clinically manifest. Papillary microcarcinoma is simply defined as a papillary carcinoma 1.0 cm or smaller in diameter. The TNM classification defines T1 as tumors smaller than 1 cm in diameter; T2 as 1 to 4 cm; T3 as larger than 4 cm; and T4 as invading beyond the thyroid capsule. Cady1 suggests a prognostic step off with lesions larger than 4 cm. Several researchers have shown that for lesions smaller than 1.5 cm in diameter, the prognosis is usually quite favorable.2,3

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