다발성 갑상샘 유두암의 임상적 특징 및 예후

Abstract

Purpose: Papillary thyroid carcinomas (PTCs) often occur as multifocal tumors. The aim of this study was to investigate the clinical features and treatment of multifocal PTC. Methods: A retrospective survey was carried out on 315 patients with PTC who underwent total thyroidectomy and central compartment neck dissection with or without lateral neck dissection from January 2007 to April 2010. The risk factors, including sex of patients, age at diagnosis, largest tumor size, extra-thyroidal extension, presence of thyroiditis, lymph node involvement, thyroid stimulating hormone and post operative follow-up results were analyzed between solitary and Multifocal PTC group. Results: Of those factors, the presence of central compartment and lateral neck lymph node and mean numbers of involvement lymph node were significantly related factors for the multifocality of the PTC. Conclusion: Multifocus is one of the clinical features of PTC. And multifocal PTCs are associated with increased risk of central and lateral neck lymph node involvement, Therefore, total thyroidectomy and central compartment neck dissection could be the standard treatments. And lateral neck node dissection should be recommended for cases with clinically positive lateral neck lymph nodes. (J Korean Surg Soc 2010;79:442-446)