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Patients with the tall-cell subtype of papillary cancer of the thyroid are more likely to have a recurrence than patients with the classic subtype
The background of the study. There are several subtypes of papillary cancer of the thyroid, the most common of which is the classical subtype. The tall-cell subtype is less common, but it is considered to be more likely to recur than the classical subtype. In this study, the characteristics and course of patients who had the tall-cell subtype were compared with those who had the classic subtype.
How the study was done. Review of the surgical pathology records of the Memorial Sloan-Kettering Cancer Center revealed 62 cases of the tall-cell subtype and 83 cases of the classic subtype of papillary cancer limited to the thyroid gland at the time of diagnosis. The definition of the tall-cell subtype was a tumor in which 
50 percent of the cells were two or more times taller than they were wide. The clinical, pathologic, and follow-up data for the two groups were compared.
The results of the study. The characteristics of the patients and the tumors in the two groups at the time of diagnosis were similar, except that invasion of the capsule of the tumor by tumor cells, the presence of tumor cells in lymph nodes in the neck, and extension of tumor cells outside the thyroid gland were more common in the tall-cell group. Most patients in both groups were treated by total thyroidectomy and lymph-node dissection, and approximately 60 percent in each group were treated with iodine-131.
Complete follow-up data were available for 109 patients in the two groups. During a median follow-up period of 3 years, 7 of 47 patients (15 percent) in the tall-cell group and 4 of 62 (6 percent) in the classic group had recurrent cancer.
The conclusions of the study. Patients with the tall-cell subtype of papillary cancer confined to the thyroid at the time of diagnosis are more likely to have recurrences than are similar patients with the classic subtype of papillary cancer.
The original article. Ghossein RA, Leboeuf R, Patel KN, Rivera M, Katabi N, Carlson DL, Tallini G, Shaha A, Singh B, Tuttle RM. Tall cell variant of papillary thyroid carcinoma without extrathyroid extension: biologic behavior and clinical implications. Thyroid 2007;17:655-61.
 Next Article: Thyroidectomy in patients with thyroid cancer is rarely complete |
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| Thyroid Digest Index | | | November 2007 Thyroid Digest |
