{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:31:43Z","timestamp":1779204703733,"version":"3.51.4"},"reference-count":51,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: With evolving guidelines favoring de-escalation in the management of papillary thyroid microcarcinoma (PTMC), options such as active surveillance and minimally invasive procedures are now considered for patients with low-risk disease. However, a subset of PTMCs\u2014particularly non-incidental cases\u2014may exhibit aggressive behavior. This study compares disease characteristics and outcomes between incidental and non-incidental PTMCs over a 10-year period. Methods: This is a single-center retrospective comparative analysis utilizing a prospectively collected database of patients referred for thyroid surgery. Results: Papillary thyroid carcinoma accounted for 86.7% of thyroid malignancies, with PTMC comprising 36.2% (137 patients). Incidental PTMC represented 109 out of 1012 patients undergoing surgery for benign thyroid disease (10.8%). Non-incidental PTMC (NIPTMC), diagnosed preoperatively and presenting clinically without coexisting thyroid disease, was identified in 28 patients (20.4%). NIPTMCs were more frequently associated with high-risk features (75% vs. 10.1%, p = 0.004), including extrathyroidal extension (21.43% vs. 7.3% p = 0.0015), positive central lymph nodes (21.43% vs. 2.8%, p = 0.0291), positive lateral lymph nodes (28.6% vs. 0% p = 0.012), and lymphovascular invasion (3.6% vs. 0%). Multifocal PTMC was seen in 37 patients (27%), of which 27 had bilobar disease. Multifocal tumors had a higher likelihood of high-risk features (48.6% vs. 14%, p = 0.007). NIPTMC was a significant predictor of multifocality (p = 0.0098). All patients underwent surgery, none opted for active surveillance. Conclusions: NIPTMC is more often associated with high-risk features and multifocality, necessitating more extensive surgery. These findings emphasize the need for careful preoperative risk stratification to guide individualized management.<\/jats:p>","DOI":"10.3390\/cancers17122029","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T04:08:06Z","timestamp":1750219686000},"page":"2029","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Papillary Thyroid Microcarcinoma in Thyroid Surgical Practice: Incidental vs. Non-Incidental: A Ten-Year Comparative Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-3662","authenticated-orcid":false,"given":"Amani A.","family":"Bashir","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, IA 52246, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed M.","family":"El-Zaheri","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ibn Sina University for Medical Sciences & Jordan Hospital, Amman 11152, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad A.","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ibn Sina University for Medical Sciences & Jordan Hospital, Amman 11152, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4052-6195","authenticated-orcid":false,"given":"Luma","family":"Fayyad","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ibn Sina University for Medical Sciences & Jordan Hospital, Amman 11152, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiman H.","family":"Obed","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ibn Sina University for Medical Sciences & Jordan Hospital, Amman 11152, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dima","family":"Alkam","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ibn Sina University for Medical Sciences & Jordan Hospital, Amman 11152, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7128-1979","authenticated-orcid":false,"given":"Abdalla Y.","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ibn Sina University for Medical Sciences & Jordan Hospital, Amman 11152, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"ref_1","unstructured":"Nimri, O., Arqoub, K., and Jemal, A. 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