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Papillary thyroid microcarcinomas: does subtyping predict aggressive clinical behavior?

Maria A Gubbiotti1, Virginia Livolsi1, Kathleen Montone1

  • 1Hospital of the University of Pennsylvania, 6 Founders, Philadelphia, PA, 19104, United States.

Human Pathology
|May 10, 2021
PubMed
Summary
This summary is machine-generated.

Papillary thyroid microcarcinomas, though often indolent, can show aggressive behavior based on histologic variants. Subtyping these small papillary thyroid cancers is crucial for predicting patient outcomes.

Keywords:
Extrathyroidal extensionFollicular variantMicrocarcinomaPapillary thyroid carcinomaTall cell variant

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Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
  • PTC presents with various morphologic variants, each with distinct clinical behaviors.
  • Papillary thyroid microcarcinomas (PTMCs) are PTCs ≤1.0 cm, often considered clinically indolent.

Purpose of the Study:

  • To investigate if histologic variants in PTMCs correlate with more aggressive clinical behavior.
  • To challenge the assumption of universal clinical indolence in PTMCs.

Main Methods:

  • Retrospective analysis of pathology archives from 2009-2020.
  • Assessment of morphologic features in papillary thyroid microcarcinomas.
  • Correlation of histologic variants with clinical behavior.

Main Results:

  • Certain histologic variants within PTMCs exhibit features associated with a more aggressive clinical course.
  • Findings suggest variability in PTMC behavior based on subtype.

Conclusions:

  • Papillary thyroid microcarcinomas should be subtyped.
  • Histologic subtyping of PTMCs can aid in predicting patient outcomes.
  • Histologic variant analysis is important for risk stratification in PTMCs.