Preoperatively diagnosed microscopic papillary thyroid cancer: an aggressive approach in selected patients with small nodules

Thyroid nodules are very common among the general population; suspicion of malignancy is a typical indication for surgery in these patients. Despite that, surgery is typically required in patients with nodules >10 mm, resection should be considered for a selected subgroup of patients with small (≤10 mm) nodules. In this study, among 150 patients who underwent thyroidectomy for thyroid nodules during a 18-month period, 19 (12.7%) had small thyroid nodules. Indication for surgery in these patients was preoperative diagnosis of papillary thyroid cancer, after an aggressive diagnostic investigation (using ultrasound-guided fine-needle aspiration) that was performed due to the recognition of specific risk factors (most commonly suspicious ultrasonographic findings, but also cervical lymphadenectomy and strong positive family history).