Medical College of Wisconsin
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High-Risk Histological Subtypes of Papillary Thyroid Carcinoma Predict More Aggressive Disease in Pediatric Patients. Pediatr Dev Pathol 2026;29(5):517-522

Date

04/24/2026

Pubmed ID

42029176

DOI

10.1177/10935266261439744

Scopus ID

2-s2.0-105037062482 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: Papillary thyroid carcinoma (PTC) is uncommon in children compared with adults. Studies have examined the significance of histologic subtype on outcomes in adults; less is known about its importance in pediatric PTC. We sought to examine the relationship between PTC histologic subtype and clinicopathologic factors in children.

METHODS: The LIS was queried for pediatric PTC thyroidectomy patients between 01/2000 and 12/2023. H&E slides were assessed by 2 pathologists for PTC histologic subtypes per the 2022 WHO Classification of Endocrine and Neuroendocrine Tumors. All patterns identified in each tumor were recorded. Relevant clinicopathologic data was collected and correlated with histology using 2-tailed heteroscedastic Student-t-tests.

RESULTS: Forty-six pediatric PTC patients were identified during the study timeframe. 16 (34.8%) tumors showed at least focal high-risk subtype morphology. The presence of any high-risk histology in any quantity correlated with higher AJCC pT stage (P = .0471), high ATA Risk Classification (P = .049), disease recurrence (P = .0357), and distant metastatic disease (P = .0034).

CONCLUSIONS: Our findings suggest that WHO-defined high-risk PTC histologic subtypes correlate with more aggressive disease in children. This correlation - observed regardless of the amount of high-risk subtype in a given tumor - suggests that these morphologic patterns may provide important prognostic insight for these children.

Author List

Parsons LN, Hopp AM, Jarzembowski JA

Authors

Amanda Hopp MD Assistant Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin
Jason A. Jarzembowski MD, PhD Senior Associate Dean, CEO CSG, Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin
Lauren Parsons MD Associate Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Female
Humans
Male
Neoplasm Staging
Prognosis
Retrospective Studies
Thyroid Neoplasms
Thyroidectomy