Borderline Thyroid Tumors: a Surgeon's Perspectives

Ki-Wook Chung; Dong Eun Song

doi:10.11106/ijt.2019.12.1.15

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Chung and Song: Borderline Thyroid Tumors: a Surgeon's Perspectives

Review Article

International Journal of Thyroidology 2019; 12(1): 15-18.

Published online: 31 May 2019

DOI: https://doi.org/10.11106/ijt.2019.12.1.15

Borderline Thyroid Tumors: a Surgeon's Perspectives

Ki-Wook Chung¹, Dong Eun Song²

¹Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea.

²Department of Pathology, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence: Ki-Wook Chung, MD, Department of Surgery, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: 82-2-3010-3962, surgeonckw@amc.seoul.kr

Received 23 April 2019 Revised 9 May 2019 Accepted 9 May 2019

The Korean Thyroid Association

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Borderline thyroid tumors are composed of hyalinizing trabecular tumor (HTT), well differentiated tumor of uncertain malignant potential (WDT-UMP), follicular tumor of uncertain malignant potential (FT-UMP) and non-invasive follicular tumor with papillary like nuclear feature (NIFTP) by World Health Organization (WHO) definition. They have different pathological feature from each other. However, it is difficult to diagnose with diagnostic imaging, fine needle aspiration (FNA) or core biopsy preoperatively. Thus, the diagnosis is usually made after diagnostic lobectomy. Main surgical concerns about borderline tumor are not performing total thyroidectomy because of relatively indolent nature of these tumors. Unfortunately, some of these tumors can be diagnosed as malignant tumor preoperatively. The other surgical concern is performing completion thyroidectomy or not after diagnostic lobectomy. Decision making is difficult even though it is generally considered that lobectomy alone is enough. In this article, we will discuss clinical features of borderline malignant tumors and surgical strategy for these tumors.

Keywords: Borderline neoplasm, Thyroid, Surgery

Figures and Tables

Fig. 1

Ultrasonographic finding of hyalinizing trabecular tumor. Typical hypoehoic feature and speculated margin are shown.

Fig. 2

Ultrasonographic finding of FT-UMP. Ovoid and solid isoechoic tumor with capsule is seen. Margin is smooth and typical feature of follicular neoplasm are shown.

Table 1

Classification of follicular patterned thyroid tumors

EFVPTC: encapsulated follicular variant papillary thyroid carcinoma, FA: follicular adenoma, FTC: follicular thyroid carcinoma, NIFTP: non-invasive follicular tumor with papillary like nuclear feature, NOS: not otherwise specified, PTC: papillary thyroid carcinoma, UMP: uncertain malignant potential, WD: well differentiated

(Adapted from Lloyd RV et al. Other encapsulated follicular patterned tumours. Lyon: IARC publication, 2017:75-80.)

Notes

This work had been presented in 2019 Spring Congress of Korean Thyroid Association.

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