In the ATA risk stratification for differentiated thyroid cancer, a 2.5 cm papillary thyroid carcinoma with microscopic extrathyroidal extension but no vascular invasion, no lymph node metastases, and no distant metastases falls into which ATA recurrence risk category?

• A ATA Intermediate risk ✓
• B ATA Low risk
• C ATA High risk
• D ATA Very high risk

Explanation

According to the 2015 ATA guidelines, microscopic extrathyroidal extension alone places a patient in the ATA Intermediate risk category (5-20% recurrence risk), regardless of tumor size and in the absence of vascular invasion or nodal metastases. Low risk includes intrathyroidal disease without vascular invasion. High risk includes macroscopic extrathyroidal extension, incomplete resection, distant metastases, or postoperative elevated thyroglobulin. There is no 'very high risk' ATA category as such—it falls under the high-risk tier.

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.