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Papillary thyroid carcinoma measuring 1.0 cm or less: an epidemiological and clinicopathological study
Imad A El Hag1, Raghad Tallab1
1Department of Pathology and Laboratory medicine, Security Forces Hospital, Riyadh, Saudi Arabia.
Frontiers in Oncology
|November 24, 2025
Summary
Papillary thyroid microcarcinoma (PTMC) incidence is rising, especially in non-screened individuals. Male sex, larger tumors, and tall cell subtype (TCS) indicate aggressive PTMC behavior.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- The incidence of papillary thyroid microcarcinoma (PTMC), defined as tumors ≤1 cm, has significantly increased over three decades.
- This rise is particularly noted in clinically relevant subgroups diagnosed preoperatively.
Purpose of the Study:
- To investigate the occurrence rates and pathological high-risk features of PTMC.
- To compare incidentally discovered PTMC with preoperatively diagnosed (non-incidental) PTMC.
Main Methods:
- Retrospective analysis of 1,408 thyroidectomies.
- Evaluation of PTMC found incidentally during surgery for benign thyroid disease.
- Assessment of PTMC diagnosed preoperatively.
Main Results:
- PTMC constituted 30.5% of resected thyroid malignancies (53% incidental, 47% non-incidental).
- Non-incidental PTMC showed higher rates of male sex predilection, larger tumor size, multiplicity, bilaterality, lymph node metastasis, and margin involvement.
- Aggressive subtypes like tall cell subtype (TCS) were more prevalent in non-incidental cases.
Conclusions:
- PTMC incidence is increasing, notably in the non-screened population.
- Male sex, tumor size >5 mm, and TCS subtype are identified as risk factors for aggressive PTMC behavior.
