유두상 갑상선 암의 큰 세포 변이(Tall Cell Variant)

Abstract

Objectives: The tall cell variant is an uncommon variant and has been known as more aggressive form of papillary thyroid carcinoma (PTC). Owing to the rarity of these thyroid cancers, their clinical behavior remains incompletely understood. To elucidate the clinicopathologic characteristics of tall cell variant, we retrospectively reviewed our surgical experience of patients with tall cell variant. Methods: Between August 1993 and July 2004, a total of 11 consecutive patients who were pathologically diagnosed with tall cell variant of papillary thyroid carcinoma were enrolled in this study. All patients underwent total (8 cases) or subtotal thyroidectomy (3 cases) with central compartment node dissections. The lateral neck dissection was added in 6 patients. After the operation, neck ultrasound and serum thyroglobulin were checked regularly during the follow-up period. Results: The mean age of the patients was 56.6years (range, 30-74years) at the time of diagnosis. 3 patients were men, and 8 were women. The mean diameter of tumor was 3.7cm(range, 1.5-6.0cm), and 6 patients had lateral neck node metastasis. Extrathyroidal extension was seen in 5 patients (45%). Loco-regional recurrence was found in 2 patients (18%), and distant metastasis in 1 patient (9%). The 5-year disease free survival rate was 68%. Conclusion: The tall cell variant of papillary thyroid carcinoma is an uncommon disease. Clinicopathologic feature and prognosis of this disease show more aggressive behaviors than ordinary papillary thyroid carcinoma. More aggressive treatment and close follow-up should be undertaken in the tall cell variant of papillary thyroid carcinoma.