Papillary Thyroid Carcinoma and Microcarcinoma

  • Ülkem Yararbaş
  • Zehra Özcan


Papillary thyroid carcinoma (PTC) is the most common thyroid cancer subtype and constitutes 80% of all thyroid malignancies. PTC lesions that are 1 cm or less in size are defined as “papillary thyroid microcarcinoma” (PTMC). The incidence of occult PTC cases detected on autopsy series is very high, ranging from 10 to 35%. With the increased use of diagnostic imaging modalities, the detection rate of thyroid cancer is increasing worldwide. Both PTC and PTMC have good prognosis. Due to indolent nature of the disease, especially in PTMC cases, both the extent of the initial surgery and the need for RAI treatment remain controversial.

In this section, two cases are presented. One of them is a PTC with lymph node metastases, and the other is a PTMC case with multifocal disease.


  1. 1.
    Sadler GP, Clark OH. Schwartz’s principles of surgery, vol. 36. 7th ed. New York: McGraw-Hill; 1999. p. 1661–87.Google Scholar
  2. 2.
    Lloyd RV, Buehler D, Khanafshar E. Papillary thyroid carcinoma variants. Head Neck Pathol. 2011;5:51–6. Scholar
  3. 3.
    Shah JP. Thyroid carcinoma: epidemiology, histology, and diagnosis. Clin Adv Hematol Oncol. 2015;13(4 Suppl 4):3–6.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Ito Y, Masuoka H, Fukushima M, Inoue H, Kihara M, Tomoda C, et al. Excellent prognosis of patients with solitary T1N0M0 papillary thyroid carcinoma who underwent thyroidectomy and elective lymph node dissection without radioiodine therapy. World J Surg. 2010;34:1285–90. Scholar
  5. 5.
    Zaydfudim V, Feurer ID, Griffin MR, Phay JE. The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery. 2008;144:1070–7. Scholar
  6. 6.
    Gilliland FD, Hunt WC, Morris DM, Key CR. Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973-1991. Cancer. 1997;79:564–73.CrossRefGoogle Scholar
  7. 7.
    Ito Y, Kudo T, Kobayashi K, Miya A, Ichihara K, Miyauchi A. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5,768 patients with average 10-year follow-up. World J Surg. 2012;36:1274–8. Scholar
  8. 8.
    Xu Y, Xu L, Wang J. Clinical predictors of lymph node metastasis and survival rate in papillary thyroid microcarcinoma: analysis of 3607 patients at a single institution. J Surg Res. 2018;221:128–34. Scholar
  9. 9.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. Scholar
  10. 10.
    Ito Y, Miyauchi A, Inoue H, Fukushima M, Kihara M, Higashiyama T, et al. An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg. 2010;34:28. Scholar
  11. 11.
    Fabián P, Fernando J, Carolina U, Angélica S, Erika A, Fernanda B, et al. Implementing the modified 2009 American Thyroid Association risk stratification system in thyroid cancer patients with low and intermediate risk of recurrence. Thyroid. 2015;25:1235–42. Scholar
  12. 12.
    Hay ID, Grant CS, van Heerden JA, Goellner JR, Ebersold JR, Bergstralh EJ. Papillary thyroid microcarcinoma: a study of 535 cases observed in a 50-year period. Surgery. 1992;112:1139–46.PubMedGoogle Scholar
  13. 13.
    Dietlein M, Luyken WA, Schicha H, Larena-Avellaneda A. Incidental multifocal papillary microcarcinomas of the thyroid: is subtotal thyroidectomy combined with radioiodine ablation enough? Nucl Med Commun. 2005;26:3–8.CrossRefGoogle Scholar
  14. 14.
    Küçük NO, Tari P, Tokmak E, Aras G. Treatment for microcarcinoma of the thyroid—clinical experience. Clin Nucl Med. 2007;32:279–81.CrossRefGoogle Scholar
  15. 15.
    Lun Y, Wu X, Xia Q, Han Y, Zhang X, Liu Z, et al. Hashimoto’s thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis. Otolaryngol Head Neck Surg. 2013;148:396–402. Scholar
  16. 16.
    Spencer C, Petrovic I, Fatemi S. Current thyroglobulin autoantibody (TgAb) assays often fail to detect interfering TgAb that can result in the reporting of falsely low/undetectable serum Tg IMA values for patients with differentiated thyroid cancer. J Clin Endocrinol Metab. 2011;96:1283–91. Scholar

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Ülkem Yararbaş
    • 1
  • Zehra Özcan
    • 1
  1. 1.Department of Nuclear MedicineEge University School of MedicineIzmirTurkey

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