Diagnosis and treatment analysis of 26 cases of diffuse sclerosing variant of papillary thyroid carcinoma
HE Run-dong
FU Qing-feng
ZHANG Shuai
SUN Ping
SUN Hui
ZHOU Le
Abstract：Objective To explore the key aspects in the diagnosis and treatment of the diffuse sclerosing variant of papillary thyroid carcinoma(DSVPTC).Methods A retrospective analysis was conducted based on 26 patients with DSVPTC treated at the Department of Thyroid Surgery,Jilin University China-Japan Union Hospital from January 2015 to September 2022.The study encompassed general patient information,ultrasound,fine-needle aspiration cytology,paraffin pathology results,and comprehensive postoperative treatment plans.Relevant literature was also reviewed.Results Among the 26 patients,the majority were females(21/26,80.8％),with an average age of 31.6 years.All patients underwent surgical treatment after preoperative diagnosis,among which 8 cases underwent total thyroidectomy with lymph node clearance(bilateral Ⅵ region,bilateral Ⅱ,Ⅲ,Ⅳ,Ⅴ regions),10 cases underwent total thyroidectomy with lymph node clearance(bilateral Ⅵ region,unilateral Ⅱ,Ⅲ,Ⅳ,Ⅴ regions),1 case underwent total thyroidectomy with lymph node clearance(bilateral Ⅵ region),3 cases underwent unilateral thyroid lobectomy and isthmus resection with lymph node clearance(bilateral Ⅵ region,unilateral Ⅱ,Ⅲ,Ⅳ,Ⅴ regions),and 4 cases underwent unilateral thyroid lobectomy and isthmus resection with lymph node clearance(bilateral Ⅵ region).Postoperative pathology revealed a significantly high rate of cervical lymph node metastasis in these cases(central region:92.3％;lateral neck region:76.9％),and 15 patients of them had concomitant Hashimoto's thyroiditis(57.7％).Additionally,4 patients were found to have concomitant classical papillary thyroid carcinoma(CPTC).Postoperatively,17 patients received iodine-131 treatment and all patients underwent endocrine suppression therapy.With regular follow-ups,the minimum follow-up time was 4 months and the maximum was 88 months.Two patients were lost to follow-up,and the median follow-up time was 19 months.There was no recurrence or metastasis during the follow-up period.Conclusion DSVPTC is more common in young females,characterized by a high rate of lymph node metastasis and complex and variable local imaging.Preoperative diagnosis should be made by combining multiple examinations.Treatment requires a more active and comprehensive strategy.
Keywords：papillary thyroid carcinomadiffuse sclerosing variantultrasonographyclinical and pathological characteristics
Publication Date：2025-09-01
Online Publishing Date：2025-10-22(First online date of this platform, not the publication date of the document)
Pages：4( 1032-1035 )