Incidental thyroid cancer in the pyramidal lobe and implications for thyroidectomy

Abstract

The embryological remnants (ERs) must be removed to achieve a safe and complete ‘total’ thyroidectomy. Residual ERs, after thyroidectomy, may cause recurrence of the initial pathology. This poses management dilemmas, including a difficult reoperation. Active search and removal of the ERs intraoperatively is essential. Primary overt malignancy is rare in ERs. Literature reports several cohort studies of same. The incidence of a micropapillary carcinoma in an ER has not been reported and this brief report describes two patients with Incidental micropapillary carcinoma in the pyramidal lobe, reiterating the need to make removal of ERs the accepted norm in total thyroidectomies.