Skip to main content
SpringerLink
Log in

Molecular characterisation and clinical correlation of papillary thyroid microcarcinoma

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

Papillary thyroid microcarcinoma (mPTC) is defined as a papillary thyroid cancer sized 10 mm or less. Despite their generally indolent clinical course and good prognosis, a subset of mPTCs shows potentially aggressive behaviour.

Methods

To search for predictors of clinical outcome of mPTCs, we retrospectively evaluated the genetic tumour profile of 100 patients (23 M/77 F, mean age ± SD 53.8 ± 13.4 years) with histologically confirmed mPTCs through analysis of BRAF, NRAS and TERT promoter mutations as well as RET/PTC translocations.

Results

Mean follow-up period was 8.4 ± 3.6 years. In 55 cases, mPTC were detected incidentally after surgery. Capsular invasion, bilateralism and multifocality were found in 11/100, 17/100 and 24/100 cases, respectively, while lymph-nodes metastases were present at diagnosis in 9/100 cases. After 3.5 ± 2.0 years, tumour relapse occurred in 6/100 cases and was locoregional in five (two in the thyroid bed, three in laterocervical lymph-nodes), while lung metastasis occurred in one case. Biochemical persistence of disease was seen in 1/100 case. Mutations occurred in 55/100 cases; BRAFV600E was the most frequently detected (49/100) and was associated with higher tumour size, bilateralism and follicular variant but not with capsular invasion. RET/PTC rearrangements were found in 2/100 cases, NRASQ61R in 4/100, while no mutations of TERT promoter gene were detected. Despite the observed association between BRAFV600E mutation and unfavourable histopathological features, we found no direct association with tumour recurrence, distant metastases and mortality.

Conclusion

In our study, the search for the most frequent genetic alterations as prognostic markers in mPTCs would not have changed the therapeutic strategy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 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 26, 1–133 (2016)

    PubMed  PubMed Central  Google Scholar 

  2. Y. Ito, A. Miyauchi, H. Oda, Low-risk papillary microcarcinoma of the thyroid: a review of active surveillance trials. Eur. J. Surg. Oncol. 44, 307–315 (2018)

    CAS  PubMed  Google Scholar 

  3. Y.J. Park, Y.A. Kim, Y.J. Lee, S.H. Kim, S.Y. Park, K.W. Kim, J.K. Chung, Y.K. Youn, K.H. Kim, D.J. Park, B.Y. Cho, Papillary microcarcinoma in comparison with larger papillary thyroid carcinoma in BRAF(V600E) mutation, clinicopathological features, and immunohistochemical findings. Head Neck 32, 38–45 (2010)

    PubMed  Google Scholar 

  4. Y.C. Hsu, J.J. Lee, M.N. Chien, M.J. Chen, C.H. Leung, S.P. Cheng, Is papillary thyroid microcarcinoma a biologically different disease? A propensity score-matched analysis. J. Surg. Oncol. 120, 1023–1030 (2019)

    CAS  PubMed  Google Scholar 

  5. L. Pagano, C. Mele, D. Arpaia, M.T. Samà, M. Caputo, S. Ippolito, C. Peirce, F. Prodam, G. Valente, G. Ciancia, G. Aimaretti, B. Biondi, How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer and their histopathological findings? Endocrine 56, 129–137 (2017)

    CAS  PubMed  Google Scholar 

  6. S.B. Edge, D.R. Byrd, C.C. Compton, A.G. Fritz, F.L. Greene, A. Trotti, Thyroid cancer staging, in: AJCC cancer staging manual, 7th edn. (Springer Verlag, New York, 2010), pp. 59–64

  7. M. Tuttle, L.F. Morris, B. Haugen, J. Shah, J.A. Sosa, E. Rohren, R.M. Subramaniam, J.L. Hunt, N.D. Perrier, Thyroid differentiated and anaplastic carcinoma, in: AJCC cancer staging manual, 8th edn. (Springer International publishing, New York, NY, USA, 2017), Chapter 73

  8. I.D. Hay, M.E. Hutchinson, T. Gonzalez-Losada, B. McIver, M.E. Reinalda, C.S. Grant, G.B. Thompson, T.J. Sebo, J.R. Goellner, Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery 144, 980–987 (2008)

    PubMed  Google Scholar 

  9. A.C. Rodrigues, G. Penna, E. Rodrigues, P. Castro, M. Sobrinho-Simões, P. Soares, The genetics of papillary microcarcinomas of the thyroid: diagnostic and prognostic implications. Curr. Genom. 18, 244–254 (2017)

    CAS  Google Scholar 

  10. J. Vinagre, A. Almeida, H. Pópulo, R. Batista, J. Lyra, V. Pinto, R. Coelho, R. Celestino, H. Prazeres, L. Lima, M. Melo, A.G. da Rocha, A. Preto, P. Castro, L. Castro, F. Pardal, J.M. Lopes, L.L. Santos, R.M. Reis, J. Cameselle-Teijeiro, M. Sobrinho-Simões, J. Lima, V. Máximo, P. Soares, Frequency of TERT promoter mutations in human cancers. Nat. Commun. 4, 2185 (2013)

    PubMed  Google Scholar 

  11. D. de Biase, G. Gandolfi, M. Ragazzi, M. Eszlinger, V. Sancisi, M. Gugnoni, M. Visani, A. Pession, G. Casadei, C. Durante, G. Costante, R. Bruno, M. Torlontano, R. Paschke, S. Filetti, S. Piana, A. Frasoldati, G. Tallini, A. Ciarrocchi, TERT promoter mutations in papillary thyroid microcarcinomas. Thyroid 25, 1013–1019 (2015)

    PubMed  Google Scholar 

  12. J. Bernstein, R.K. Virk, P. Hui, A. Prasad, W.H. Westra, G. Tallini, A.J. Adeniran, R. Udelsman, C.T. Sasaki, S.A. Roman, J.A. Sosa, M.L. Prasad, Tall cell variant of papillary thyroid microcarcinoma: clinicopathologic features with BRAFV600E mutational analysis. Thyroid 23, 1525–1531 (2013)

    CAS  PubMed  Google Scholar 

  13. F. Li, G. Chen, C. Sheng, A.M. Gusdon, Y. Huang, Z. Lv, H. Xu, M. Xing, S. Qu, BRAFV600E mutation in papillary thyroid microcarcinoma: a meta-analysis. Endocr. Relat. Cancer 22, 159–168 (2015)

    CAS  PubMed  PubMed Central  Google Scholar 

  14. M. Li, X.-Y. Zhu, J. Lv, K. Lu, M.-P. Shen, Z.-L. Xu, Z.-S. Wu, Risk factors for predicting central lymph node metastasis in papillary thyroid microcarcinoma (CN0): a study of 273 resections. Eur. Rev. Med. Pharmacol. Sci. 21, 3801–3807 (2017)

    CAS  PubMed  Google Scholar 

  15. G. Tallini, D. De Biase, C. Durante, G. Acquaviva, M. Bisceglia, R. Bruno, M.L. Bacchi Reggiani, G.P. Casadei, G. Costante, N. Cremonini, L. Lamartina, D. Meringolo, F. Nardi, A. Pession, K.J. Rhoden, G. Ronga, M. Torlontano, A. Verrienti, M. Visani, S. Filetti, BRAF V600E and risk stratification of thyroid microcarcinoma: a multicenter pathological and clinical study. Mod. Pathol. 28, 1343–1359 (2015)

    CAS  PubMed  Google Scholar 

  16. G. Tallini, A. De Leo, A. Repaci, D. de Biase, M.L.B. Reggiani, D. Di Nanni, F. Ambrosi, C. Di Gioia, G. Grani, K.J. Rhoden, E. Solaroli, F. Monari, S. Filetti, C. Durante, Does the site of origin of the microcarcinoma with respect to the thyroid surface matter? A multicenter pathologic and clinical study for risk stratification. Cancers. 12, 246 (2020)

  17. Y. Chen, P.M. Sadow, H. Suh, K.E. Lee, J.Y. Choi, Y.J. Suh, T.S. Wang, C.C. Lubitz, BRAF(V600E) is correlated with recurrence of papillary thyroid microcarcinoma: a systematic review, multi-institutional primary data analysis, and meta-analysis. Thyroid 26, 248–255 (2016)

    CAS  PubMed  Google Scholar 

  18. J.H. Gu, Y.N. Zhao, R.L. Xie, W.J. Xu, D.L. You, Z.F. Zhao, F. Wang, J. Fei, Analysis of risk factors for cervical lymph node metastasis of papillary thyroid microcarcinoma: a study of 268 patients. BMC Endocr. Disord. 19, 1–5 (2019)

    Google Scholar 

  19. K.J. Kim, S.G. Kim, J. Tan, X. Shen, D. Viola, R. Elisei, E. Puxeddu, L. Fugazzola, C. Colombo, B. Jarzab, A. Czarniecka, A.K. Lam, C. Mian, F. Vianello, L. Yip, G. Riesco-Eizaguirre, P. Santisteban, C.J. O’Neill, M.S. Sywak, R. Clifton-Bligh, B. Bendlova, V. Sýkorová, M. Xing, BRAF V600E status may facilitate decision-making on active surveillance of low-risk papillary thyroid microcarcinoma. Eur. J. Cancer 124, 161–169 (2020)

    CAS  PubMed  Google Scholar 

  20. C. Ugolini, R. Giannini, C. Lupi, G. Salvatore, P. Miccoli, A. Proietti, R. Elisei, M. Santoro, F. Basolo, Presence of BRAF V600E in very early stages of papillary thyroid carcinoma. Thyroid 17, 381–388 (2007)

    CAS  PubMed  Google Scholar 

  21. G. Ardito, L. Revelli, E. Giustozzi, M. Salvatori, G. Fadda, F. Ardito, N. Avenia, A. Ferretti, L. Rampin, S. Chondrogiannis, P.M. Colletti, D. Rubello, Aggressive papillary thyroid microcarcinoma: prognostic factors and therapeutic strategy. Clin. Nucl. Med. 38, 25–28 (2013)

    PubMed  Google Scholar 

  22. C. Lupi, R. Giannini, C. Ugolini, A. Proietti, P. Berti, M. Minuto, G. Materazzi, R. Elisei, M. Santoro, P. Miccoli, F. Basolo, Association of BRAF V600E mutation with poor clinicopathological outcomes in 500 consecutive cases of papillary thyroid carcinoma. J. Clin. Endocrinol. Metab. 92, 4085–4090 (2007)

    CAS  PubMed  Google Scholar 

  23. V. Rodolico, D. Cabibi, G. Pizzolanti, P. Richiusa, N. Gebbia, A. Martorana, A. Russo, M.C. Amato, A. Galluzzo, C. Giordano, BRAFV600E mutation and p27kip1 expression in papillary carcinomas of the thyroid ≤1 cm and their paired lymph node metastases. Cancer 110, 1218–1226 (2007)

    PubMed  Google Scholar 

  24. F. Frasca, C. Nucera, G. Pellegriti, P. Gangemi, M. Attard, M. Stella, M. Loda, V. Vella, C. Giordano, F. Trimarchi, E. Mazzon, A. Belfiore, R. Vigneri, BRAF(V600E) mutation and the biology of papillary thyroid cancer. Endocr. Relat. Cancer 15, 191–205 (2008)

    CAS  PubMed  Google Scholar 

  25. X. Lee, M. Gao, Y. Ji, Y. Yu, Y. Feng, Y. Li, Y. Zhang, W. Cheng, W. Zhao, Analysis of differential BRAF V600E mutational status in high aggressive papillary thyroid microcarcinoma. Ann. Surg. Oncol. 16, 240–245 (2009)

    PubMed  Google Scholar 

  26. F. Basolo, L. Torregrossa, R. Giannini, M. Miccoli, C. Lupi, E. Sensi, P. Berti, R. Elisei, P. Vitti, A. Baggiani, P. Miccoli, Correlation between the BRAF V600E mutation and tumor invasiveness in papillary thyroid carcinomas smaller than 20 millimeters: analysis of 1060 cases. J. Clin. Endocrinol. Metab. 95, 4197–4205 (2010)

    CAS  PubMed  Google Scholar 

  27. K.-L. Lin, O.-C. Wang, X.-H. Zhang, X.-X. Dai, X.-Q. Hu, J.-M. Qu, The BRAF mutation is predictive of aggressive clinicopathological characteristics in papillary thyroid microcarcinoma. Ann. Surg. Oncol. 17, 3294–3300 (2010)

    PubMed  Google Scholar 

  28. N. Kurtulmus, M. Duren, U. Ince, M. Cengiz Yakicier, O. Peker, O. Aydın, E. Altiok, S. Giray, H. Azizlerli, BRAF(V600E) mutation in Turkish patients with papillary thyroid cancer: strong correlation with indicators of tumor aggressiveness. Endocrine 42, 404–410 (2012)

    CAS  PubMed  Google Scholar 

  29. R.K. Virk, A.L. Van Dyke, A. Finkelstein, A. Prasad, J. Gibson, P. Hui, C.G. Theoharis, T. Carling, S.A. Roman, J.A. Sosa, R. Udelsman, M.L. Prasad, BRAFV600E mutation in papillary thyroid microcarcinoma: a genotype-phenotype correlation. Mod. Pathol. 26, 62–70 (2013)

    CAS  PubMed  Google Scholar 

  30. X. Zheng, S. Wei, Y. Han, Y. Li, Y. Yu, X. Yun, X. Ren, M. Gao, Papillary microcarcinoma of the thyroid: clinical characteristics and BRAF(V600E) mutational status of 977 cases. Ann. Surg. Oncol. 20, 2266–2273 (2013)

    PubMed  Google Scholar 

  31. J.Y. Lim, S.W. Hong, Y.S. Lee, B.-W. Kim, C.S. Park, H.-S. Chang, J.Y. Cho, Clinicopathologic implications of the BRAF(V600E) mutation in papillary thyroid cancer: a subgroup analysis of 3130 cases in a single center. Thyroid 23, 1423–1430 (2013)

    CAS  PubMed  Google Scholar 

  32. E.D. Rossi, M. Martini, S. Capodimonti, C.P. Lombardi, A. Pontecorvi, V.G. Vellone, G.F. Zannoni, L.M. Larocca, G. Fadda, BRAF (V600E) mutation analysis on liquid-based cytology-processed aspiration biopsies predicts bilaterality and lymph node involvement in papillary thyroid microcarcinoma. Cancer Cytopathol. 121, 291–297 (2013)

    CAS  PubMed  Google Scholar 

  33. Y. Yang, C. Chen, Z. Chen, J. Jiang, Y. Chen, L. Jin, G. Guo, X. Zhang, T. Ye, Prediction of central compartment lymph node metastasis in papillary thyroid microcarcinoma. Clin. Endocrinol. 81, 282–288 (2014)

    CAS  Google Scholar 

  34. M. Afkhami, A. Karunamurthy, S. Chiosea, M.N. Nikiforova, R. Seethala, Y.E. Nikiforov, C. Coyne, Histopathologic and Clinical Characterization of Thyroid Tumors Carrying the BRAF(K601E) Mutation. Thyroid 26, 242–247 (2016)

    CAS  PubMed  Google Scholar 

  35. E. Macerola, L. Torregrossa, C. Ugolini, S. Bakkar, P. Vitti, G. Fadda, F. Basolo, BRAFK601E mutation in a follicular thyroid adenoma: a case report. Int. J. Surg. Pathol. 25, 348–351 (2017)

    PubMed  Google Scholar 

  36. M. Kim, M.J. Jeon, H.-S. Oh, S. Park, T.Y. Kim, Y.K. Shong, W.B. Kim, K. Kim, W.G. Kim, D.E. Song, BRAF and RAS mutational status in noninvasive follicular thyroid neoplasm with papillary-like nuclear features and invasive subtype of encapsulated follicular variant of papillary thyroid carcinoma in Korea. Thyroid 28, 504–510 (2018)

    CAS  PubMed  Google Scholar 

  37. R. Corvi, M. Martinez-Alfaro, H.R. Harach, M. Zini, M. Papotti, G. Romeo, Frequent RET rearrangements in thyroid papillary microcarcinoma detected by interphase fluorescence in situ hybridization. Lab. Investig. 81, 1639–1645 (2001)

    CAS  PubMed  Google Scholar 

  38. A.U. Bastos, G. Oler, B.H.N. Nozima, R.A. Moysés, J.M. Cerutti, BRAF V600E and decreased NIS and TPO expression are associated with aggressiveness of a subgroup of papillary thyroid microcarcinoma. Eur. J. Endocrinol. 173, 525–540 (2015)

    PubMed  Google Scholar 

  39. G. Tallini, M. Santoro, M. Helie, F. Carlomagno, G. Salvatore, G. Chiappetta, M.L. Carcangiu, A. Fusco, RET/PTC oncogene activation defines a subset of papillary thyroid carcinomas lacking evidence of progression to poorly differentiated or undifferentiated tumor phenotypes. Clin. Cancer. Res. 4, 287–294 (1998)

    CAS  PubMed  Google Scholar 

  40. L. Pagano, C. Mele, M.T. Samà, M. Zavattaro, M. Caputo, L. De Marchi, S. Paggi, F. Prodam, G. Aimaretti, P. Marzullo, Thyroid cancer phenotypes in relation to inflammation and autoimmunity. Front Biosci. 23, 2267–2282 (2018)

    CAS  Google Scholar 

  41. X. Liu, J. Bishop, Y. Shan, S. Pai, D. Liu, A.K. Murugan, H. Sun, A.K. El-Naggar, M. Xing, Highly prevalent TERT promoter mutations in aggressive thyroid cancers. Endocr. Relat. Cancer 20, 603–610 (2013)

    PubMed  PubMed Central  Google Scholar 

  42. X. Liu, S. Qu, R. Liu, C. Sheng, X. Shi, G. Zhu, A.K. Murugan, H. Guan, H. Yu, Y. Wang, H. Sun, Z. Shan, W. Teng, M. Xing, TERT promoter mutations and their association with BRAF V600E mutation and aggressive clinicopathological characteristics of thyroid cancer. J. Clin. Endocrinol. Metab. 99, 1130–1136 (2014)

    Google Scholar 

  43. M. Melo, A.G. Da Rocha, J. Vinagre, R. Batista, J. Peixoto, C. Tavares, R. Celestino, A. Almeida, C. Salgado, C. Eloy, P. Castro, H. Prazeres, J. Lima, T. Amaro, C. Lobo, M.J. Martins, M. Moura, B. Cavaco, V. Leite, J.M. Cameselle-Teijeiro, F. Carrilho, M. Carvalheiro, V. Máximo, M. Sobrinho-Simões, P. Soares, TERT promoter mutations are a major indicator of poor outcome in differentiated thyroid carcinomas. J. Clin. Endocrinol. Metab. 99, 754–765 (2014)

    Google Scholar 

  44. G. Gandolfi, M. Ragazzi, A. Frasoldati, S. Piana, A. Ciarrocchi, V. Sancisi, TERT promoter mutations are associated with distant metastases in papillary thyroid carcinoma. Eur. J. Endocrinol. 172, 403–413 (2015)

    CAS  PubMed  Google Scholar 

  45. R. Liu, J. Bishop, G. Zhu, T. Zhang, P.W. Ladenson, M. Xing, Mortality risk stratification by combining BRAF V600E and TERT promoter mutations in papillary thyroid cancer genetic duet of BRAF and TERT promoter mutations in thyroid cancer mortality. JAMA Oncol. 3, 202–208 (2017)

    PubMed  Google Scholar 

  46. M. Eszlinger, K. Böhme, M. Ullmann, F. Görke, U. Siebolts, A. Neumann, C. Franzius, S. Adam, T. Molwitz, C. Landvogt, B. Amro, A. Hach, B. Feldmann, D. Graf, A. Wefer, R. Niemann, C. Bullmann, G. Klaushenke, R. Santen, G. Tönshoff, V. Ivancevic, A. Kögler, E. Bell, B. Lorenz, G. Kluge, C. Hartenstein, I. Ruschenburg, R. Paschke, Evaluation of a two-year routine application of molecular testing of thyroid fine-needle aspirations using a seven-gene panel in a primary referral setting in Germany. Thyroid 27, 402–411 (2017)

    CAS  PubMed  Google Scholar 

  47. C. Bellevicine, R. Sgariglia, I. Migliatico, E. Vigliar, M. D’Anna, M.A. Nacchio, N. Serra, U. Malapelle, M. Bongiovanni, G. Troncone, Different qualifiers of AUS/FLUS thyroid FNA have distinct BRAF, RAS, RET/PTC, and PAX8/PPARg alterations. Cancer Cytopathol. 126, 317–325 (2018)

    CAS  PubMed  Google Scholar 

  48. C. Bellevicine, I. Migliatico, R. Sgariglia, M. Nacchio, E. Vigliar, P. Pisapia, A. Iaccarino, D. Bruzzese, F. Fonderico, D. Salvatore, B. Biondi, S. Masone, V. Novizio, F. Scavuzzo, D. Serino, M. De Palma, M.G. Chiofalo, G. Botti, L. Pezzullo, V. Nuzzo, S. Spiezia, G. De Chiara, S. Iorio, G. Conzo, G. Docimo, A. Faggiano, M. Bongiovanni, U. Malapelle, A. Colao, M. Triassi, G. Troncone, Tiroide network.: evaluation of BRAF, RAS, RET/PTC, and PAX8/PPARg alterations in different Bethesda diagnostic categories: a multicentric prospective study on the validity of the 7-gene panel test in 1172 thyroid FNAs deriving from different hospitals in South Italy. Cancer Cytopathol. 128, 107–118 (2019)

    PubMed  Google Scholar 

  49. T.E. Angell, M.G. Lechner, J.K. Jang, A.J. Correa, J.S. LoPresti, A.L. Epstein, BRAFV600E in papillary thyroid carcinoma is associated with increased programmed death ligand 1 expression and suppressive immune cell infiltration. Thyroid 24, 1385–1393 (2014)

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Endocrinology, Department of Translational Medicine, University Hospital “Maggiore della Carità”, University of Eastern Piedmont, Novara, Italy

    Maria Teresa Samà, Chiara Mele, Oriana Monzeglio, Paolo Marzullo & Gianluca Aimaretti

  2. Laboratory of Molecular Oncology, Fondazione Edo ed Elvo Tempia, Ponderano, Biella, Italy

    Enrico Grosso, Sara Laurora & Maria Scatolini

  3. Division of General Medicine, Istituto Auxologico Italiano, IRCCS, San Giuseppe Hospital, Piancavallo, Verbania, Italy

    Chiara Mele & Paolo Marzullo

  4. Pathology Department, University Hospital “Maggiore della Carità”, University of Eastern Piedmont, Novara, Italy

    Renzo Boldorini

  5. ENT Division, University Hospital “Maggiore della Carità”, University of Eastern Piedmont, Novara, Italy

    Paolo Aluffi Valletti

  6. Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza, Torino, Italy

    Loredana Pagano

Authors
  1. Maria Teresa Samà
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Enrico Grosso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Mele
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Laurora
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Oriana Monzeglio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paolo Marzullo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Renzo Boldorini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paolo Aluffi Valletti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Gianluca Aimaretti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Maria Scatolini
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Loredana Pagano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Teresa Samà.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by Comitato Etico Interaziendale A.O.U. “Maggiore della Carità”, ASL Biella (BI), ASL Novara (NO), ASL Verbano Cusio Ossola (VCO) and was performed in line with the principles of the Helsinki Declaration.

Informed consent

All participants provided written informed consent before inclusion.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Samà, M.T., Grosso, E., Mele, C. et al. Molecular characterisation and clinical correlation of papillary thyroid microcarcinoma. Endocrine 71, 149–157 (2021). https://doi.org/10.1007/s12020-020-02380-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-020-02380-8

Keywords

Search

Navigation