Histopathology in H&N pathologies in the third millennium

Vol. 117: Issue 2 - April 2025

Evaluation of papillary thryoid carcinoma and its variants: multifocality in thyroid lobectomy and completion thyroidectomy - a single tertiary center retrospective study

Authors

Carmine Bruno , Pietro Tralongo , Federica Vegni , Angela Feraco , Qianqian Zhang , Belen Padial-Urtueta , Angela Carlino , Alfredo Pontecorvi , Guido Fadda , Marco Raffaelli , Luigi Maria Larocca , Lino Pantanowitz , Esther Diana Rossi

Key words: Fine needle aspiration cytology, thyroid cancer, lobectomy, total thyroidectomy, personalized medicine
Publication Date: 2025-05-21

Abstract

Aims. The American Thyroid Association (ATA) updated guidelines for the treatment of thyroid cancer, leading to a less aggressive approach depending on clinical-pathological features. As a result, the possibility to perform lobectomy versus total thyroidectomy has significantly increased. The majority of thyroid cancers are indolent with an excellent prognosis, while only 15% of patients with well-differentiated carcinoma, including papillary thyroid carcinoma (PTC), have locally advanced thyroid cancer (LATC) at diagnosis. We reviewed our practice in treating thyroid carcinoma over the last decade.
Methods. From January 2010 to December 2020, 1057 patients with uninodular benign and malignant thyroid lesions were reviewed. Results. Among these cases, 77% were women with a median age of 49.3 years. The series involved 307 malignant diagnoses (29.05%) including 196 (61.6%) classic PTC and 38 (12%) aggressive variants of PTC, mostly tall cell variant (30 cases, 9.4%). Among malignant cases, multifocality was microscopically documented in 84 cases (26.4%). Using the ATA distribution of risk, there were 239 cases in the low risk and 68 in the intermediate risk categories. Second surgery was assessed in a total of 150 cases, showing 42 cases with additional thyroid cancer foci in the other lobe (26 single vs 16 multiple foci). Ten cases had metastatic perithyroidal lymph nodes.
Conclusion. Our data could be the basis for performing a longitudinal study in order to establish which risk factors can predict bilateral involvement and to suggest a tailored surgical approach.

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Authors

Carmine Bruno - Division of Endocrinology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Pietro Tralongo - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Federica Vegni - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Angela Feraco - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Qianqian Zhang - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Belen Padial-Urtueta - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Angela Carlino - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Alfredo Pontecorvi - Division of Endocrinology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy;

Guido Fadda - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Marco Raffaelli - Division of Endocrine-Surgery-Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Luigi Maria Larocca - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

Lino Pantanowitz - 4Department of Pathology, Pittsburg University, Pennsylvania, USA

Esther Diana Rossi - Division of Anatomic Pathology and Histology Fondazione Policlinico Universitario“Agostino Gemelli”-IRCCS, Rome Italy

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Copyright (c) 2025 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Bruno, C., Tralongo, P., Vegni, F., Feraco, A. ., Zhang, Q., Padial-Urtueta, B. ., Carlino, A., Pontecorvi, A., Fadda, G., Raffaelli, M., Larocca, L. M., Pantanowitz, L., & Rossi, E. D. (2025). Evaluation of papillary thryoid carcinoma and its variants: multifocality in thyroid lobectomy and completion thyroidectomy - a single tertiary center retrospective study. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 117(2). Retrieved from https://www.pathologica.it/article/view/1346
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