Papillary thyroid carcinoma (PTC)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-THYROID-PAPILLARY |
|---|---|
| Type | Disease |
| Aliases | PTCPapillary thyroid carcinomaПапілярна карцинома щитовидної залози |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-CNS-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8260/3 |
|---|---|
| icd_o_3_topography | ["C73"] |
| icd_10 | C73 |
| who_classification | WHO Endocrine Tumours 5th ed (2022): Papillary thyroid carcinoma (follicular cell origin) |
Notes
Differentiated thyroid carcinoma — most indolent of common cancers. Standard care: surgery → risk-stratified RAI ablation → TSH suppression → calibrated thyroglobulin (Tg) monitoring. Radioiodine-refractory progressive disease is the trigger for systemic therapy: - Multikinase TKI 1L: lenvatinib (SELECT) or sorafenib (DECISION). - Targeted by genotype: * BRAF V600E (~50% PTC): dabrafenib + trametinib (MARCH/REINK compassionate-use; FDA tumor-agnostic 2022 BRAF V600E approval for solid tumors); single-agent dabrafenib also active. * RET fusion: selpercatinib (LIBRETTO-531; positive 2024) and pralsetinib (ARROW) — selpercatinib FDA-approved for RET-fusion+ thyroid cancer. * NTRK fusion: larotrectinib / entrectinib (tumor-agnostic). * Re-differentiation strategies: short-course MAPK inhibitor (selumetinib / dabrafenib + trametinib) restoring RAI uptake — under study. Aggressive variants (tall cell, hobnail, columnar, diffuse sclerosing) upstage to higher recurrence-risk groups even when small.
Used By
Actionability
BMA-NTRK-FUSION-THYROID-PAPILLARY- NTRK fusion in papillary thyroid carcinoma (~1-2% sporadic, higher in radiation-induced d...BMA-RET-FUSION-THYROID-PAPILLARY- RET fusion in papillary thyroid carcinoma (PTC) — ~5-10% sporadic, enriched in radiation-...BMA-TERT-THYROID- TERT promoter mutations (C228T or C250T) occur in ~10–15% of papillary thyroid cancer (PT...
Algorithms
ALGO-THYROID-PAPILLARY-1L- ALGO-THYROID-PAPILLARY-1L
Disease
DIS-MTC- Medullary thyroid carcinoma (MTC)DIS-THYROID-ANAPLASTIC- Anaplastic thyroid carcinoma (ATC)
Indication
IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-OBSERVATION- IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-OBSERVATIONIND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-SURVEILLANCE- IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-SURVEILLANCEIND-THYROID-PAPILLARY-RAI-REFRACTORY-LENVATINIB- IND-THYROID-PAPILLARY-RAI-REFRACTORY-LENVATINIB
Questionnaires
QUEST-THYROID-PAPILLARY-1L-STUB- Papillary thyroid carcinoma — first line
Red flag
RF-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION- Hashimoto's thyroiditis (chronic autoimmune lymphocytic thyroiditis, positive anti-TPO an...RF-COWDEN-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in the PTEN gene (Cowden syndro...RF-COWDEN-FAMILY-HISTORY-SUSPICION- Family pedigree suggestive of Cowden syndrome / PTEN hamartoma tumor syndrome (PHTS): any...RF-OCC-IONIZING-RADIATION-PREVENTION- Documented historical occupational exposure to ionizing radiation — typical high-risk occ...RF-THYROID-PAPILLARY-FRAILTY-AGE- Age ≥75 with ECOG ≥2 or ≥2 comorbidities — lenvatinib full-dose (24 mg) poorly tolerated;...RF-THYROID-PAPILLARY-HIGH-RISK-BIOLOGY- Papillary thyroid carcinoma with adverse molecular / clinical features: BRAF V600E (~60%...RF-THYROID-PAPILLARY-INFECTION-SCREENING- Active or latent infection requiring resolution / prophylaxis before initiating long-dura...RF-THYROID-PAPILLARY-ORGAN-DYSFUNCTION- Baseline organ dysfunction precluding standard lenvatinib / sorafenib multikinase inhibit...RF-THYROID-PAPILLARY-TRANSFORMATION-PROGRESSION- PTC transformation into anaplastic thyroid carcinoma component (DTC→ATC dedifferentiation...RF-WERNER-CONFIRMED-CARRIER- Confirmed biallelic germline pathogenic / likely-pathogenic variants in WRN (RECQL2; Wern...