caa a22 4500 475803795 CHVBK 20180406123745.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010227 doi (NATIONALLICENCE)springer-10.1007/s002680010227 Occult Micro Medullary Thyroid Carcinoma: Therapeutic Strategy and Follow-up [Elektronische Daten] [Jean Louis Peix, Petra Braun, Masood Saadat, Nicole Berger, Mansour El Khazen, Frédérique Mancini] Twenty micro medullary thyroid carcinomas (MTCs) were found in histologic specimens of 19 patients in our department from 1990 to 1998. There were 14 women and 5 men, with a median age of 63 years. The indication for surgery was goiter in 12 patients and a solitary nodule in 7 patients (three differentiated cancers). Altogether, 18 patients had unifocal micro-MTCs with a median diameter of 3.6 mm. One patient had a bilateral MTC (3 and 5 mm, respectively). Surgical procedures consisted of 9 total thyroidectomies and 10 lobectomies or subtotal thyroidectomies. Of these 10 patients, 4 underwent reoperation (totalization). One was operated on 48 months after a positive pentagastrin test: There was no thyroid residual tumor but three lymph node micrometastases. Among the six patients in whom thyroid tissue was left, a 91-year-old woman died of unrelated cause and the five others remain disease-free without biologic abnormalities at follow-ups of 18 to 70 months. Considering the aggressiveness of MTCs, total thyroidectomy with central compartment dissection is theoretically indicated. However, among the nine total thyroidectomies and four secondary totalizations associated with at least central compartment dissection, no other thyroid lesion was observed and only one case of lymph node microinvasion was found. Because of the morbidity associated with reoperation and neck dissection, we propose that it is indicated only for microcarcinomas > 5 mm in diameter, in cases of an abnormal response to pentagastrin, or when it is difficult to ensure prolonged follow-up of the patient. Société Internationale de Chirurgie, 2000 Peix Jean Louis Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut Braun Petra Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut Saadat Masood Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut Berger Nicole Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut El Khazen Mansour Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut Mancini Frédérique Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1373-1376 0364-2313 24:11<1373 2000 24 268 https://doi.org/10.1007/s002680010227 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010227 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Peix Jean Louis Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut NATIONALLICENCE 700 1- Braun Petra Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut NATIONALLICENCE 700 1- Saadat Masood Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut NATIONALLICENCE 700 1- Berger Nicole Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut NATIONALLICENCE 700 1- El Khazen Mansour Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut NATIONALLICENCE 700 1- Mancini Frédérique Department of Surgery, Hôpital de l'Antiquaille, 69321 Lyon Cédex 05, France, FR aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1373-1376 0364-2313 24:11<1373 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer