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Question

Which of the following statements regarding papillary thyroid cancer are correct?
1. It is the most common malignant tumour of thyroid gland.
2. It is more common in young females.
3. It has propensity for haematogenous spread.
4. Distant metastases are uncommon.

Select the correct answer using the code given below.

The correct answer is
1, 2 and 4

Papillary Thyroid Cancer: Correct Statements

Papillary thyroid carcinoma (PTC) is the most common histological type of thyroid malignancy, and it has well-established epidemiological and biological features that distinguish it from other thyroid cancers such as follicular, medullary, and anaplastic carcinoma.

Analysis of Each Statement

  • Statement 1: It is the most common malignant tumour of thyroid gland.

    This is correct. Papillary carcinoma accounts for approximately 80–85% of all thyroid malignancies, making it by far the most common type of thyroid cancer.

  • Statement 2: It is more common in young females.

    This is correct. PTC shows a strong female preponderance (female-to-male ratio of roughly 3:1) and characteristically affects a younger age group (commonly 20–40 years), unlike anaplastic carcinoma, which typically occurs in the elderly.

  • Statement 3: It has propensity for haematogenous spread.

    This is incorrect. Papillary thyroid cancer characteristically spreads via the lymphatic route, with early and frequent metastasis to regional (cervical) lymph nodes. Haematogenous (blood-borne) spread is uncommon and, when it occurs, is a late event — this pattern is more typical of follicular thyroid carcinoma, which classically spreads haematogenously to lungs and bone.

  • Statement 4: Distant metastases are uncommon.

    This is correct. Because PTC predominantly disseminates via lymphatics rather than blood vessels, distant metastases (to lung, bone, etc.) are relatively uncommon at presentation, and even when nodal disease is extensive, the overall prognosis remains excellent.

Conclusion

Statements 1, 2, and 4 correctly describe papillary thyroid cancer — it is the most common thyroid malignancy, occurs more often in young females, and rarely produces distant metastases because of its predominantly lymphatic (not haematogenous) pattern of spread. Statement 3 is false and correctly excluded.

Therefore, the correct answer is 1, 2 and 4.

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Important Questions from Neck & Breast Surgery

  1. No increased relative risk of invasive breast carcinoma based on histopathological examination of benign breast tissue is for all of the following EXCEPT:
  2. Which of the following statements regarding Paget's disease of nipple are correct?
    1. It represents benign pathology of nipple areola complex
    2. It is eczema like condition of nipple and areola
    3. Erosion of nipple is seen
    4. Nipple biopsy is required for definitive diagnosis
    Select the correct answer using the code given below:
  3. A gentleman of 60 years presented with a brawny swelling of the sub- mandibular region with inflammatory oedema of mouth and putrid halitosis. Most likely he is suffering from
  4. A 25 year old female patient with previous history of neck irradiation presents with thyroid swelling for last 6 months. The patient is clinically euthyroid. On examination, the right lobe of thyroid gland is enlarged with presence of ipsilateral cervical lymphadenopathy. The most probable clinical diagnosis in this patient is
  5. Serum thyroglobulin level is an important tumor marker for
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