Abstract
The term thyroid neoplasm incorporates tumors that originate from follicular cells and those that arise from parafollicular cells (C cells). Differentiated thyroid cancer, which originates from follicular cells, includes papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), oncocytic cell carcinoma (Hürthle), poorly differentiated carcinoma, and anaplastic thyroid carcinoma (ATC). PTC tends to have an indolent clinical course with low morbidity and mortality. However, this entity has a broad range of biological and clinical behavior that can result in disease recurrence and death, depending on patient and tumor characteristics and the initial treatment approach. PTC is the most common form of well-differentiated thyroid cancer (WDTC) and based on the most recent statistics, accounts for approximately 89.4% of all thyroid malignancies. PTC appears as an irregular solid or cystic nodule in normal thyroid parenchyma. PTC has the propensity for lymphatic invasion, but it is less likely to have hematogenous spread. Around 11% of patients with PTC present with distant metastases outside the neck and mediastinum. This manuscript with review the current understanding of the epidemiology, pathology, molecular characteristics, prognostic factors, and dynamic risk stratification of PTC centered on an evidence-based and personalized approach.
Highlights
Papillary thyroid cancer (PTC) tends to have an indolent clinical course with low morbidity and mortality
Differentiated thyroid cancer, which originates from follicular cells, includes papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), oncocytic cell carcinoma (Hürthle), poorly differentiated carcinoma, and anaplastic thyroid carcinoma (ATC)
Chromosomal rearrangements were the first oncogenic events identified in PTC [16] [17], encompassing the rearranged during transfection (RET) proto-oncogene, which arises from a paracentric inversion of chromosome 10 [16] [17]
Summary
Papillary thyroid cancer (PTC) tends to have an indolent clinical course with low morbidity and mortality. This entity has a broad range of biological and clinical behavior that can result in disease recurrence and death, depending on patient and tumor characteristics and the initial management approach. PTC is the most common form of well-differentiated thyroid cancer (WDTC) and based on the most recent statistics, accounts for approximately 89.4% of all thyroid malignancies, and is the predominant histology observed in patients exposed to radiation [1] [2] [3] [4] [5]. Notwithstanding its well-differentiated characteristics, PTC may be blatantly or minimally invasive. These tumors may spread to other organs [10]. Regional lymph node metastases were thought to be aberrant (supernumerary) thyroids because they contained well-differentiated PTC, but occult regional lymph node metastases are known to be a very common finding in patients with PTC [9] [11] [12] [13]
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