MON-456 Clinical Profile of Thyroid Papillary Microcarcinoma in Brazil

INTRODUCTION: The thyroid papillary microcarcinoma (TPMC) is defined as a tumor ≤ 1 centimeter. This variant of thyroid papillary carcinoma is generally characterized by slow progression and minimal invasion. Although the TPMC subtype usually has good prognosis, itʼs early recognition has clinical relevance because it may present with regional lymph node metastasis, as well as increased risk of recurrence. AIM OF THE STUDY: The aim of the study is to identify the epidemiologic profile of the population diagnosed with TPMC, as well as the signs and symptoms observed in these patients. This study intends to guide early clinical suspicion of thyroid tumors; in order to propose assertive forms of management and prevention of undesirable outcomes. PATIENTS AND METHODS: Retrospective cohort study based on medical records of patients diagnosed with TPMC at University Hospital of Brasilia-Brasil, from 1999 to 2017. The clinical aspects analysed were: gender; race; age of the patient when the diagnosis was made; symptoms reported by the patients regarding the pathology and comorbidities. RESULTS: Fifty-eight patients who underwent thyroidectomy for variable thyroid criteria were included in this study. 87,93% were women, (seven fold higher female prevalence of the TPMC). Mean age of diagnosis was 42, 94 ± 11,4. Regarding the race, the majority of the patients had self-entitled as mixed race, which corresponds to 39,65% of the sample. Symptoms reported included dysphagia (29,31%), dyspnea (17,24%) and feeling of neck compression (13,79%). Even though these aspects of the clinical approach are significant diagnosis tools, only 26,5% of the patients in this sample attested those kinds of signs/symptoms. Considering that actual clinical manifestation is relatively rare, total inclusion of the anatomic specimen is useful in this unsettling scenarios. Among the most commonly reported comorbidities, benign thyroid affections were the most prominent, such as multinodular goiter and hypothyroidism. CONCLUSION: Analysis of the data endorses that the TPMC does not have a well defined clinic presentation. Nonetheless, dysphagia is the most reported symptom. Analysis of the data pointed to a higher prevalence of the pathology in women in their 40s, which can be used as parameter of investigation on patients that have symptoms that cannot be explained by other pathologies. Although TPMC usually presents with good prognosis, the non incidental groups may present with aggressive behavior and should be treated as papillary thyroid carcinoma. Despite that, fine needle aspiration and ultrassonografy are the preferable methods in the evaluation of thyroid tumors.