Análisis del comportamiento clínico de las variantes histopatológicas no clásicas del carcinoma papilar de tiroides en población del hospital de Solca Guayaquil, 2014 -2018.

Abstract

Introduction: Thyroid cancer is the most frequent malignant neoplasm worldwide. In Latin American countries, it occurs in 9 out of every 100,000 inhabitants each year, with a high prevalence in females and a low mortality rate. Objective: To describe the clinical behavior of the histological variants of papillary thyroid carcinoma in patients treated at SOLCA National Oncological Institute of Guayaquil-Ecuador in the period of 2014-2018. Materials and Methods: This research is descriptive, retrospective, observational and longitudinal. Results: With a sample of 92 clinical records of patients with PTC, a higher proportion was identified in the age group between 41-60 years old, with an average of 48.83 years and a maximum of 85 years; likewise, 88% of the female sex showed PTC. The variant with the highest incidence identified was the encapsulated follicular with 46.7%, followed by the infiltrating follicular with 20.7%, to a lesser extent the hobnail and the sclerosing with 2.2%. Regarding poor prognostic factors, 42% had invasion of the thyroid capsule, 27% had extrathyroid invasion, 52% lymph node metastases, 40% extranodal metastases, 36% lymphovascular invasion, and 32% venous invasion. The encapsulated variant in general showed a low to intermediate risk of recurrence; however, in other non-classical variants such as tall cells, hobnail, and columnar cell variants, the risk of recurrence was high. Conclusions: The most aggressive morphological variants (tall cells, columnar and diffuse sclerosing) presented greater factors of poor prognosis (extrathyroid invasion, lymph node metastasis, extranodal metastases and lymphovascular invasion) than those considered less aggressive within the non-classical papillary group.