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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. Medical management of thyrotoxic crisis includes all of the following EXCEPT:
  2. First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:
  3. All of the following are major subtypes of breast cancer based on Gene array analysis EXCEPT:
  4. Which of the following statements regarding lymphoedema following breast cancer treatment are correct?
    1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
    radiotherapy
    2. Precipitating cause like LN metastasis is a major determinant
    3. The condition is often painful
    4. Oedematous limb is susceptible to bacterial infection
    Select the correct answer using the code given below:
  5. No increased relative risk of invasive breast carcinoma based on histopathological examination of benign breast tissue is for all of the following EXCEPT:
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