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Objective: Evaluation of the biological behavior of micropapillary thyroid carcinomas
Design: Retrospective review of a prospective database
Setting: Tertiary academic referral center
Patients: 27 patients with tall cell variant microcarcinomas who underwent total thyroidectomy, with or without lymph node dissection
Interventions: Review of patient medical records
Main Outcome Measures: disease recurrence and disease-related mortality
Results: There were 4 men and 23 women, aged 33 to 74 years (median age, 56 years). Median follow-up was 60 months (range 48 to 168 months). Tumor size in microTCV patients ranged from 2-10mm (median, 7mm). Extrathyroidal extension and lymphovascular invasion were observed in 9 (33%) and 4 (15%) tumors, respectively. The BRAF v600E mutation was present in 23 patients (85%). Seven of the 27 patients (26%) presented with advanced stage disease (stage III or IV), however none of these patients had tumor recurrence. Tumor recurrence occurred in only two of twenty-seven patients (7.4%); one female and one male, both 65 years of age, with stage I disease at initial presentation.  Time to recurrence was six years and seven years, respectively. There was no disease-related mortality.
Conclusions:
The microTCV subtype of PTC is associated with more aggressive features at presentation. Advanced stage disease at time of diagnosis may not be indicative of risk of tumor recurrence. Long-term follow-up of a larger number of microTCV patients will improve our understanding of the biological behavior of this subset of micropapillary thyroid carcinomas.