Preoperative, operative, and postoperative pathological features in thyroid papillary carcinoma with and without capsule invasion

Abstract

Aims:Approximately 80-85% of thyroid malignancies are papillary thyroid cancer (PTC). This study evaluated the relationship between thyroid capsule invasion (TCI) in PTC and macroscopic histopathological findings.Methods:A single-center, retrospective study was conducted using the medical records of adult patients who underwent PTC surgery. The patients were classified as TCI (+) or TCI (-) based on the postoperative pathological examination. Tumor localization, calcification, and multifocality were evaluated between the two groups.Results:The study included 236 patients (mean age: 44.3±12.0 years, female sex: 76.7%). Preoperative basic characteristics, comorbidities, thyroid function status, nodule calcification, halo border irregularity, and nodule diameter on ultrasonography were similar between the two groups. However, more TCI (+) patients had positive or suspicious fine needle aspiration biopsy findings preoperatively. The duration of surgery was longer in TCI (+) patients (86 minutes vs. 75 minutes, p1 mm was more common in TCI (+) vs. TCI (-) patients (47.3% vs. 81.8%, p<0.001). Postoperative macroscopic pathological reports showed that middle lobe tumor localization was more common in TCI (+) (38.2%) than in TCI (-) (23.2%) patients (p=0.028), whereas tumor localization in the upper pole, lower pole, and isthmus was not different. Multifocal involvement (41.8% vs. 38.1%) was also similar between the two groups.Conclusions:This study showed that fine needle biopsy positivity and nodule localization in the middle thyroid gland were more common in TCI (+) PTC patients as detected postoperatively. The other macroscopic pathological findings were not different.

Keywords

• thyroid cancer
• thyroid papillary carcinoma
• thyroid capsule invasion
• lymph node metastasis
• thyroglobulin