# Clinical and morphological predictors of metastasis in papillary thyroid microcarcinoma

## TL;DR

This study identifies clinical and histological features that predict lymph node metastasis in small thyroid cancers.

## Contribution

The study identifies specific clinical and histological predictors of metastasis in papillary thyroid microcarcinomas.

## Key findings

- Younger age, classical histological subtype, tumor budding, and psammoma bodies are linked to higher metastasis risk.
- Concomitant multinodular hyperplasia is associated with lower metastasis risk.
- Combining these features improves risk stratification for PTMC patients.

## Abstract

Papillary thyroid microcarcinomas (PTMCs), defined as papillary thyroid carcinomas measuring ≤1 cm, are frequently diagnosed incidentally and are generally associated with favorable outcomes. However, a significant subset of patients develops regional lymph node metastases. This study aimed to identify clinical and morphological features associated with metastatic spread in PTMCs.

A total of 100 cases were retrospectively analyzed, including 50 with confirmed lymph node metastases and 50 without. A detailed histological assessment included evaluation of tumor subtype, nuclear features, presence of psammoma bodies, tumor “buds,” fibrosis, and other parameters. Clinical variables such as age, sex, body mass index, and presence of the BRAF V600E mutation were also considered.

Logistic regression revealed that younger age, classical histological subtype, tumor “budding,” and presence of psammoma bodies were independently associated with an increased risk of regional metastases, while concomitant multinodular hyperplasia was negatively associated.

The combination of these features may enhance risk stratification and guide the clinical management of PTMC patients, including decisions on surgical extent and follow-up strategies. Our findings support the relevance of comprehensive histological and clinical evaluation in predicting the metastatic potential of PTMCs.