{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:37:58Z","timestamp":1791862678879,"version":"4.3.4"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of papillary thyroid microcarcinoma (PTMC) measuring 1 cm or less has noticeably increased over the past 30 years, particularly among clinically significant subgroups that are diagnosed chiefly preoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study investigated the rate of occurrence and the pathological high-risk features of PTMC discovered incidentally during thyroidectomies for benign thyroid diseases, as well as those diagnosed preoperatively (non-incidental), in a sample of 1,408 thyroidectomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PTMC accounted for 30.5% of all resected malignant thyroid tumors, with 53% being incidental and 47% non-incidental. The incidence of incidental PTMC has increased twofold over the past seven years, from 4.5% to 9.0%, while the incidence of the non-incidental subgroup has increased tenfold, from 0.9% to 9.0%. Compared to incidental cases, non-incidental cases were more likely to affect males, exhibited significantly larger tumors (7.2 mm versus 3.7 mm), and had higher rates of multiplicity (49.4% vs. 23.6%) and bilaterality (36.7% vs. 16.7%). Non-incidental cases also had higher rates of lymph node metastasis (25.9% vs. 4.2%) and greater margin involvement (34.4% vs. 16.7%). Extrathyroidal extension occurred exclusively in approximately 2.5% of the non-incidental cases. The most aggressive PTMC subtype is the tall cell subtype (TCS), followed by the classic subtype, which is observed in 30% and 29% of non-incidental cases, respectively. Follicular subtypes exhibit indolent behavior, as observed in 11% of non-incidental cases. An account of the TCS morphology is also provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of PTMC has dramatically increased in the non-screened population. Male sex, tumor size &amp;gt;5 mm, and TCS subtype are risk factors for aggressive behavior.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1678065","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T06:23:29Z","timestamp":1762410209000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Papillary thyroid carcinoma measuring 1.0 cm or less: an epidemiological and clinicopathological study"],"prefix":"10.3389","volume":"15","author":[{"given":"Imad A.","family":"El Hag","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Tallab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/pin.12737","article-title":"The new 4th 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