Papillary Microcarcinoma

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Abstract
Background: Papillary microcarcinoma (PMC) is increasing in incidence because of diagnosis by ultrasound‐guided fine‐needle aspiration cytology.Methods: Between January 1966 and December 1995, we treated 6019 patients with papillary cancer; among them, 2070 patients with PMC were studied.Results: PMC is essentially very similar to papillary cancer that is 11 mm or larger and has a very good prognosis. Smaller tumors and younger patients have a better prognosis. Among PMC, larger tumors (6–10 mm) recur in 14% at 35 years compared with 3.3% in patients with smaller tumors. Patients older than 55 years have recurrence in 40% at 30 years, with a worse prognosis than younger patients who have a recurrence rate of less than 10%. Extracapsular invasion by the primary tumor also has a higher recurrence rate. The majority of recurrences are in the neck. Therefore, annual ultrasound of the neck is effective for recurrence surveillance.Conclusion: Papillary microcarcinoma is similar to larger papillary carcinomas with tumor characteristics and age‐based recurrence rate that extends for many years, justifying long surveillance after surgery.