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Comparative Analysis of Incidental and Non‐Incidental Papillary Thyroid Microcarcinoma Outcomes: Implications on Management Recommendations

Year: 2026

Type: article

Abstract: INTRODUCTION: Papillary thyroid microcarcinomas (PTMC) are defined by the World Health Organisation (WHO) as tumours measuring ≤ 10 mm. Incidental PTMCs, or lesions discovered postoperatively on histological examination, are less extensively studied compared with lesions diagnosed preoperatively through cytology, particularly in terms of demographics, histopathological features and long-term outcomes. This study aimed to compare outcomes between these patients. METHODS: A single-centre retrospective cohort analysis of data from the St. James's University Hospital Head and Neck tumour board spanning from 2013 to 2023 was conducted. A total of 152 patients diagnosed with PTMCs and neck nodes ≤ 1 cm were identified during this period. Of these, 55 were incidental and 47 were non-incidental PTMCs included in the final analysis. RESULTS: Significant differences were observed between the two subgroups in terms of the size of the largest tumour focus (7.8 mm vs. 3.9 mm, p < 0.001), the presence of aggressive histologic variants (9.2% vs. 0.9%, p = 0.002) and the frequency of neck dissections (8.8% vs. 0.0%, p < 0.001). However, no recurrences occurred in either group. CONCLUSION: This comprehensive 10-year retrospective review found few differences in the presentation of incidental and non-incidental microcarcinoma, with low recurrence rates and excellent outcomes. These findings, with overall low numbers, provide hypothesis-generating evidence that this group may be suitable for discharge to primary care for further follow-up.

Source: Clinical Endocrinology

DOI: 10.1111/cen.70127