Papillary thyroid microcarcinomas: does subtyping predict aggressive clinical behavior?

Hum Pathol. 2021 Aug:114:28-35. doi: 10.1016/j.humpath.2021.04.015. Epub 2021 May 7.

Abstract

The most common malignant neoplasm affecting the thyroid gland is papillary thyroid carcinoma (PTC). PTC can demonstrate a number of morphologic variants including, but not limited to, classic, follicular, and tall cell. Each of these morphologic subtypes carry distinct clinical characteristics such that certain variants, like tall cell, behave more aggressively than others. PTCs measuring less than or equal to 1.0 cm are classified as microcarcinomas. Although these lesions are thought to be clinically indolent, we hypothesized that, like their larger counterparts, certain histologic variants may lead to worse patient outcomes. To test our hypothesis, we analyzed our pathology archives between the years 2009 and 2020 for papillary thyroid microcarcinomas and assessed whether different morphologic features correlated with more aggressive clinical behavior. Our findings suggest that certain variants exhibit features that portend a more worrisome clinical course and thus papillary thyroid microcarcinomas should be subtyped to help predict patient outcome.

Keywords: Extrathyroidal extension; Follicular variant; Microcarcinoma; Papillary thyroid carcinoma; Tall cell variant.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Papillary / classification
  • Carcinoma, Papillary / pathology*
  • Carcinoma, Papillary / therapy
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Thyroid Neoplasms / classification
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / therapy
  • Tumor Burden
  • Young Adult

Supplementary concepts

  • Papillary Thyroid Microcarcinoma