Some medical definitions remain the same for many years, others change due to the progress in the diagnostic tools, which are able to distinguish markers and symptoms until then undetectable. Occult thyroid carcinoma is a general term indicating clinically different situations, whereas the incidentally detected papillary thyroid microcarcinoma is the most important from the clinical point of view. It is fundamental, for therapeutic management, to determine biological parameters which would define a small group of papillary thyroid microcarcinomas with aggressive biological behaviour. The most promising genetic and molecular markers for papillary thyroid carcinoma risk stratification are discussed in this review. Preoperative evaluation of these markers, obtained through analysis of ultrasonography-guided fine needle biopsy specimens of papillary thyroid microcarcinoma, could be very valuable in guiding treatment of this type of cancer.

Alcune definizione mediche restano invaiate nel tempo, mentre altre si modificano seguendo i progressi che consentono in campo diagnostico di definire markers e sintomi fino a quel momento non valutabili. Il carcinoma occulto della tiroide è un termine generico che indica differenti situazioni cliniche, mentre il microcarcinoma papillifero della tiroide diagnosticato incidentalmente resta l’entità clinica maggiormente significativa. È fondamentale ai fini della programmazione terapeutica la possibilità di identificare dei parametri biologici in grado di differenziare i microcarcinomi papilliferi sulla base della loro aggressività. In questa review sono stati rivisti i markers genetici e molecolari del microcarcinoma papillifero della tiroide più significativi ai fini di una loro possibile stratificazione. La valutazione pre-operatoria di questi markers, ottenuti attraverso l’analisi di agobiopsie ecoguidate di microcarcinomi papilliferi, potrebbe essere utile per la pianificazione terapeutica di questo tipo di carcinoma.

Department of Otorhinolaryngology and Head and Neck Surgery Charles University Prague University Hospital Motol Prague Czech Republic

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Aktuelle Behandlungskonzepte des papillären Schilddrüsenmikrokarzinoms