Incidentally discovered papillary thyroid microcarcinoma in patients undergoing thyroid surgery for benign disease

Endocrine. 2022 Aug;77(2):325-332. doi: 10.1007/s12020-022-03089-6. Epub 2022 May 31.


Introduction: The incidence of thyroid carcinoma has grown significantly over the last few decades. A possible explanation is the increased diagnosis of small thyroid microcarcinoma (TMc). TMc reach a maximum diameter of ≤1 cm, identified during histopathology examination following a thyroidectomy performed for reasons not pertaining to malignancy. This study aims to investigate the prevalence of papillary thyroid microcarcinoma (PTMc) according to the benign pathology that refers patients to surgery and its trend evolution.

Methods: Retrospective cohort analysis of 1815 patients who underwent total thyroidectomy for non-malignant diseases in the 2005-2020 period.

Results: The mean age of the subjects was 53.5 years, with a higher proportion of women (1481, 82.1%). A total of 167 PTMc (9.3%) were incidentally discovered. A multivariate logistic regression analysis was performed, showing no differences in prevalence according to sex or age in patients with PTMc compared to final benign histology. Multinodular goiter increases the risk of PTMc with an odds ratio of 2.2 (p = 0.001) compared to Hashimoto's thyroiditis and Graves' disease (GD). There is a statistically significant increase in the incidence of PTMc in the group operated in the 2017-2020 vs. 2005-2008 period (p = 0.005).

Conclusion: The overall prevalence of PTMc in patients who underwent thyroid surgery for the benign disease was 9.3%. Thyroid nodular hyperplasia was the most frequent benign pathology associated with PTMc compared to Hashimoto's or GD. Gender and age were not correlated with the prevalence of TMc. Over the years, surgical findings of PTMc have grown, particularly in the 2017-2020 period.

Keywords: Benign thyroid disease; Incidental; Papillary thyroid microcarcinoma; Thyroid surgery.

MeSH terms

  • Carcinoma, Papillary* / complications
  • Carcinoma, Papillary* / diagnosis
  • Female
  • Goiter / complications
  • Goiter / surgery
  • Graves Disease / complications
  • Graves Disease / surgery
  • Hashimoto Disease / complications
  • Hashimoto Disease / surgery
  • Humans
  • Incidental Findings*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyroid Diseases* / complications
  • Thyroid Diseases* / surgery
  • Thyroid Neoplasms* / complications
  • Thyroid Neoplasms* / diagnosis
  • Thyroidectomy*

Supplementary concepts

  • Papillary Thyroid Microcarcinoma