Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy

Authors

  • Maria Luisa Carcangiu MD,

    1. Institutes of Anatomic Pathology and Nuclear Medicine, and the Nuclear Medicine Service of the Unitā Sanitasia Locale 10-D, Florence, Italy
    2. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
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    • Associate Professor of Anatomic Pathology, University of Florence Medical School, Florence, Italy.

  • Giancarlo Zampi MD,

    1. Institutes of Anatomic Pathology and Nuclear Medicine, and the Nuclear Medicine Service of the Unitā Sanitasia Locale 10-D, Florence, Italy
    2. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
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    • Professor of Anatomic Pathology and Director of the Institute of Anatomic Pathology, University of Florence Medical School, Florence, Italy.

  • Alberto Pupi MD,

    1. Institutes of Anatomic Pathology and Nuclear Medicine, and the Nuclear Medicine Service of the Unitā Sanitasia Locale 10-D, Florence, Italy
    2. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
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    • Associate Professor of Nuclear Medicine, University of Florence Medical School, Florence, Italy.

  • Antonio Castagnoli MD,

    1. Institutes of Anatomic Pathology and Nuclear Medicine, and the Nuclear Medicine Service of the Unitā Sanitasia Locale 10-D, Florence, Italy
    2. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
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    • Attending Physician, Nuclear Medicine Service of Unitā Sanitaria Locale 10-D, Florence, Italy.

  • Juan Rosai MD

    Corresponding author
    1. Institutes of Anatomic Pathology and Nuclear Medicine, and the Nuclear Medicine Service of the Unitā Sanitasia Locale 10-D, Florence, Italy
    2. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
    • Box 76 Mayo, University of Minnesota Hospitals, Minneapolis, MN 55455
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    • Professor of Laboratory Medicine and Pathology and Director of Anatomic Pathology, University of Minnesota Medical School, Minneapolis, Minnesota.

    • A substantial amount of this work was done during a sabbatical furlough that one of the authors (J.R.) spent at the Institute of Anatomic Pathology of the University of Florence Medical School, Florence Italy.


Abstract

A clinicopathologic study of 241 cases of papillary thyroid carcinoma treated at the University of Florence Medical School, Florence, Italy is presented. The features of greatest prognostic value were patient's age at presentation, small tumor size, total encapsulation, extrathyroid extension, multicentricity, and presence of distant metastases. The prognosis of the disease was not influenced by the pattern of tumor growth, presence of solid areas, initial presence or subsequent development of cervical lymph node metastases, type of initial thyroid operation, performance of neck dissection, or prophylactic administration of radioactive iodine. It is concluded that conservative thyroid surgery in the form of lobectomy, without neck dissection or prophylactic administration of iodine 131 (131I), constitutes adequate therapy for most cases of papillary thyroid carcinoma. More extensive therapy should be considered for older patients and for those in whom the tumor exhibits extrathyroid extension or easily detectable multicentricity.

Ancillary