Characteristics and Difficulties in the Management of Thyroid Microcarcinoma in Algeri

Introduction: Thyroid cancer prevalence has increased significantly in recent years, including in Algeria, which primarily concerned microcarcinoma making 30 to 50% of new diagnosed cases. Despite its good prognosis, its management remains highly controversial and debated. We aim to describe characteristics of thyroid microcarcinoma in a series from eastern Algeria monitored in the endocrinology department of Constantine University Hospital and to report the difficulties pertaining to its management. Patients and Methods: A descriptive retrospective study including patients followed and monitored in the thyroid cancer register in the endocrinology department of Constantine University Hospital during the period between January 2015 and December 2018. Results: Of 70 cases of thyroid microcarcinomas, mean age was 44 years [17-84 years] and 94% were women. 94% of the cases were papillary micro carcinomas; the two most frequent variants were the classic papillary and the vesicular variant of papillary carcinoma in 80% of cases. The diagnosis was made following a multi-nodular goiter exploration in 60% and thyroid function was normal in 50%. Moltifocality and bilaterality were reported in 27% and 5.71% of cases respectively. The most common surgical procedure was total thyroidectomy (96%), without lymph node dissection (86%). Classification of the initial risk was impossible due to the insufficient data in 28% of cases. 52% of patients received RAI therapy and 81% were in complete remission. Conclusion: Thyroid micro carcinoma has a good prognosis; however, its management faces several issues, mainly the stratification of risk which would be a source of overtreatment.