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(Vienna, 27 April 2011) In the international top journal “Annals of Surgical Oncology” a study of Nikolaus Neuhold and Peter Birner was recently published which makes a rethink necessary for the diagnosis and treatment of “papillary microcarcinoma”.

Papillary microcarcinoma of the thyroid is a relatively common form of cancer. But so far it was not clear how aggressive this disease really is and how radical treatment therefore has to be. Treatment measures range from minimal surgery on to complete removal of the thyroid with subsequent therapy using radioactive iodine.

But, based on the results of the now published study, both the diagnosis “cancer” and also the radical interventions in the therapy seem excessive to the authors. In this the researchers studied the pathogenesis of around 760 patients who had a papillary microcarcinoma diagnosed between 1975 and 2004. After surgery only three patients suffered a recurrence of the disease, but this was able to be treated easily and there were no serious consequences.

It is also notable that the microcarcinomas were sometimes discovered “incidentally”. The patients came for treatment because of different thyroid problems and it was only when they were examined precisely that around a third of the affected people were diagnosed with the carcinomas. The detection rate would therefore have been higher if the original diagnosis had been more precise.

Peter Birner says on the results: “The data clearly shows that papillary microcarcinoma of the thyroid represents a very low-grade disease whose detection rate correlates with the accuracy of the histological assessment. Standardisation of a more precise diagnosis would be desirable here. The rate of progression of papillary microcarcinomas discovered incidentally is also so low that, based on our data, it is recommended to replace the term ‘carcinoma’ with the term ‘papillary microtumour with low malignant potential’ with these tumours. This would mean the affected patients would not have to face an extremely stressful ‘cancer diagnosis’.“

(Picture: Papillary microcarcinoma amid normal thyroid tissue)

Participating scientists:
Senior consultant Dr. Nikolaus Neuhold
, lead author, head of the Pathological-Bacteriological Institute at the Empress Elisabeth Hospital of the Vienna Hospital Association.
Ao.Univ. Prof. Dr. Peter Birner, head of the study, Clinical Institute of Pathology at the Medical University of Vienna.

Publication in „Annals of Surgical Oncology“ (ePaper):
» Incidental Papillary Microcarcinoma of the Thyroid - Further Evidence of a Very Low Malignant Potential: A Retrospective Clinicopathological Study With Up to 30 Years of Follow-Up
Nikolaus Neuhold, MD, Andrea Schultheis, MD, Michael Hermann, MD, Gabriela Krotla, MD,
Oskar Koperek, MD, and Peter Birner, MD
Ann Surg Oncol DOI 10.1245/s10434-011-1663-x