According to the ATA 2015 guidelines risk stratification, a patient with multifocal papillary thyroid microcarcinoma (each focus <1 cm) with minor extrathyroidal extension is classified as:

• A Intermediate risk — total thyroidectomy with consideration of RAI ablation ✓
• B Very low risk — active surveillance is the preferred approach
• C Low risk — lobectomy is sufficient without RAI ablation
• D High risk — total thyroidectomy with mandatory RAI ablation and systemic therapy

Explanation

ATA 2015 classifies multifocal papillary microcarcinoma with minor extrathyroidal extension as intermediate risk (not low or very low risk, which requires intrathyroidal unifocal disease). Total thyroidectomy is recommended and selective use of RAI should be considered. High risk requires gross extrathyroidal extension, incomplete resection, or distant metastases. Very low risk (unifocal PTMC, intrathyroidal) may qualify for active surveillance in select patients.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.