The ATA (American Thyroid Association) risk classification for differentiated thyroid cancer categorizes a patient with a 2 cm papillary thyroid cancer, no extrathyroidal extension, R0 resection, no lymph node metastases, and no adverse histological features as which risk category?

• A Very low risk
• B Low risk ✓
• C Intermediate risk
• D High risk

Explanation

ATA 2015 guidelines classify differentiated thyroid cancer risk: Very low risk includes unifocal microcarcinoma (<1 cm) without extrathyroidal extension; Low risk includes intrathyroidal papillary thyroid cancer (1–4 cm), no vascular invasion, no aggressive variants, no lymph node metastases (or <5 microscopic N1a with all deposits <0.2 cm); Intermediate risk includes microscopic extrathyroidal extension, vascular invasion, aggressive histology, or >5 lymph node metastases with deposits 0.2–3 cm; High risk includes gross extrathyroidal extension, incomplete resection, or distant metastases. A 2 cm intrathyroidal PTC with R0 resection and negative nodes is low risk.

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

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Written and medically reviewed by the StethoPrep medical team.