Microcarcinoma papilar de tiroides en adolescente: Extensión de la tiroidectomía y necesidad de terapia ablativa

objective: to report the case of a teenager with papillary thyroid microcarcinoma, pathology with controversial therapeutic management. clinical case: adolescent women 15 years of age, who presented a painless lowly progressive increase in volume of 4 years of evolution on the left lateral region of theneck. subsequently dysphagia with tenderness, reason why subtotal thyroidectomy was performed. pathologic study reported papillary microcarcinoma of 6 mm in diameter, without capsular infiltration. she was referred for evaluation by nuclear medicine and monitoring by the endocrinology service. few bilateral eutopic thyroid remnants were found. a papillary tumor<1 cm, in the absence of capsular invasion, lymphinfiltration, local or distant metastasis, was considered low risk, so it was decided not to complete the thyroidectomy and do not administer ablative therapy. it started with levothyroxine suppressive therapy. it was decided to follow up the patient by clinical, laboratory (thyroid profile and thyroglobulin, in spite of thyroid remnants, to detect elevations above baseline) and ultrasound. currently the patient is in good general condition with stable tracking variables. conclusion: papillary thyroid microcarcinoma has low risk of recurrence and mortality. the extent of surgery is controversial, total thyroidectomy is indicated for some and expanded lobectomy for others. postoperative ablative therapy has not proven beneficial and levothyroxine suppressive therapy is useful. according to the clinical course and response to treatment, the risk of recurrence and mortality should be re-evaluated periodically, always prevailing clinical judgment.