A Clinical Study of Differentiated Thyroid Carcinoma.

We analyzed 48 cases of differentiated thyroid carcinoma which were operated on for the first time at this hospital in the nine-year period from 1986 to 1994. Histologically, 45 were papillary adenocarcinomas, and 3 were follicular adenocarcinomas. Twelve of the patients were men and 36 were women. All 12 male cases were papillary adenocarcinomas, while 33 of the female cases were papillary adenocarcinomas and 3 were follicular adenocarcinomas. Patient age ranged from 11 to 76, with a mean age of 48.6 for men and 50.5 for women. The total average patient age was 50.0 years.The TNM classification breakdown, as specified by the standards for thyroid carcinoma, was as follows: 11 cases of type T1, 23 cases of T2, 4 cases of T3, and 10 cases of T4. The breakdown by N classification was as follows: 33 cases of N0, 14 cases of N1a, and 1 case of N1b. There was only one M1 case, which involved metastasis to the lungs. Tumors recurred post-operatively in 4 men, one of whom died from respiratory failure following metastasis to the lungs. All recurring tumors were well differentiated papillary adenocarcinomas, but there was no correlation between histopathological differentiation and prognosis.These results indicated that prognosis may be poor in some cases of thyroid carcinoma, even when they are well differentiated papillary adenocarcinomas. Therefore, diagnostic standards which address the biological behavior of cancer, are required.