Among the variants of papillary thyroid carcinoma, which variant is associated with the most aggressive behavior, higher rates of extrathyroidal extension, and loss of BRAF V600E association in favor of other molecular alterations?

• A Follicular variant
• B Diffuse sclerosing variant
• C Warthin-like variant
• D Tall cell variant ✓

Explanation

The tall cell variant of papillary carcinoma has tumor cells at least twice as tall as wide, behaves more aggressively with extrathyroidal extension and nodal metastasis, and occurs in older patients. While conventional papillary carcinoma strongly associates with BRAF V600E, tall cell tumors frequently show alternative alterations such as TERT promoter mutations alongside BRAF, worsening outcome. The follicular variant is generally indolent, and Warthin-like tumors have a favorable course.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.