The tall cell variant of papillary thyroid carcinoma: Clinical and pathological features and outcomes
C. Regalbuto1, P. Malandrino1, F. Frasca1, G. Pellegriti1, R. Le Moli1, R. Vigneri1, and V. Pezzino1,2
1Endocrinology, Department of Clinical and Molecular Bio-Medicine, University of Catania, Garibaldi-Nesima Hospital; 2Center of Diabetology and Endocrine Diseases, Cannizzaro Hospital, Catania, Italy

Background: The tall cell variant (TCV) is a relatively rare variant of papillary thyroid cancer. Since a controversy exists whether or not the TCV has a worse outcome, the aim of our study was to retrospectively compare the clinicopathological features and outcomes in a group of TCV patients and a larger group of patients with classical papillary thyroid carcinoma (cPTC). Subjects and methods: Data from 30 TCV and 293 cPTC patients were analyzed. Among the 293 cPTC, we also selected a “high-risk” cPTC group (no.=103) that was treated with the same protocol used for the TCV patients. All data were managed by Cox analysis. Results: Compared to all cPTC patients, TCV subjects displayed only a significantly higher rate of extrathyroid extension. At multivariate analysis, TCV was not an independent variable for the prediction of a high risk of persistent/recurrent disease. At the last follow-up observation, there was no difference in the disease status between the TCV and all cPTC patients. Moreover, “high-risk” cPTC patients had a significant increase in persistent/recurrent disease. Conclusions: In our study, although the TCV histotype is associated with a higher prevalence of extrathyroid extension, it is characterized by an outcome that is not significantly different from that of all cPTC patients and is more favorable than that of “high-risk” cPTC patients. Only those TCV patients classified as “high risk” based on specific pathological and clinical features, according to current guidelines, should be treated aggressively, such as with a total thyroidectomy, neck lymph node dissection or ablative radioiodine treatment. (J. Endocrinol. Invest. 36: 249-254, 2013) ©2013, Editrice Kurtis

DOI: published: [« Back]  [Accepted manuscript]