[Occult papillary thyroid cancer].

Abstract

The clinical and morphological aspects of occult sclerosing carcinoma of the thyroid are presented on the basis of a ten-year review of the surgically removed thyroids in Geneva and from the study of thyroid glands obtained from 133 consecutive autopsies. The 15 cases found in the surgical material represented 7.7% of all malignant thyroid tumours and one fifth of the papillary carcinomas. Occult tumours are found at a mean age of 46.6 years and predominate in women. Clinically, two thirds presented as nodular goiters, two cases as primary hyperplasia and one as primary hyperparathyroidism. Three out of 15 cases presented clinically with a cervical lymph node metastasis. Treatment was conservative in all cases and consisted of subtotal thyroidectomy and/or elective lymphadenectomy, followed by medical suppression of TSH. Follow-up in 11 cases showed a single recurrence in a cervical lymph node, while the other 10 cases have been disease free for 4 to 13 years. In the autopsy series 3 thyroid glands (2.3%) contained occult tumours, two of which were microcarcinomas. The Genevan series compares with other European and American studies but differs from the much higher incidence in the Japanese.