Korean J Otorhinolaryngol-Head Neck Surg.  2013 Nov;56(11):711-716. 10.3342/kjorl-hns.2013.56.11.711.

Clinical Characteristics of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma

• Kim YB
• Park H
• Choi JY
• Park SH
• Lee GH
• Lee BC
• Lee MC
• Choi IJ

• KMID: 1922212
• DOI: http://doi.org/10.3342/kjorl-hns.2013.56.11.711

Abstract

BACKGROUND AND OBJECTIVES
Diffuse sclerosing variant (DSV) is a rare variant of papillary thyroid carcinoma (PTC) and has been adopted as a histologic variant. Due to the limited number of cases and the heterogeneity of the tumor's clinical behavior, there is no consensus for DSV's optimal treatment and post-operative follow-up. The purpose of this study is to evaluate the clinical manifestation, recurrence and prognosis of 10 patients with DSV.
SUBJECTS AND METHOD
We retrospectively reviewed ten consecutive patients in whom DSV was first observed between 2000 and 2012. All patients are presently under active follow-up at Korea Cancer Center Hospital. Patients underwent a total thyroidectomy with central compartment and laterocervical lymph node dissection only when this involvement was documented by pre-surgery ultrasound examination with fine needle aspiration biopsy.
RESULTS
The mean observation interval was 41.6 months. The ratio of male to female was 1 : 9, and the age of incidence was 34.2+/-11.4. The average size of mass was measured 2.9+/-1.9 cm. Upon the diagnosis, eight cases had central and lateral neck lymph nodal metastasis, which was confirmed during the operation. There was no distant metastasis, but one case was confirmed with lung metastasis during the follow-up period. There was no mortality during the follow-up periods in all ten cases.
CONCLUSION
DSV of PTC has high risk characteristics of large tumor size, extrathyroidal extension, and multiple lymph nodes metastasis. We may expect comparable outcome with classical PTC by proper surgical treatment and postoperative radioactiveiodine ablation.

Keyword

Diffuse sclerosing variant; Papillary thyroid carcinoma

MeSH Terms

Biopsy, Fine-Needle
Carcinoma
Consensus
Diagnosis
Female
Follow-Up Studies
Humans
Incidence
Korea
Lung
Lymph Node Excision
Lymph Nodes
Male
Mortality
Neck
Neoplasm Metastasis
Population Characteristics
Prognosis
Recurrence
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Ultrasonography