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Jae Bok Lee 1 Article
Tumor Sprouting in Papillary Thyroid Carcinoma Is Correlated with Lymph Node Metastasis and Recurrence
Eunjung Lee, Wonkyung Jung, Jeong-Soo Woo, Jae Bok Lee, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek-hui Kim
Korean J Pathol. 2014;48(2):117-125.   Published online April 28, 2014
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AbstractAbstract PDF

Identification of poor prognostic factors in papillary thyroid carcinoma (PTC) patients is important for the patients' care and follow-up. We can sometimes see small tumor clusters without desmoplasia and no evidence of lymphatic emboli around the main tumor mass of PTC. We termed this form of tumor clustering, 'tumor sprouting,' and determined whether these tumors correlate with lymphovascular invasion, lymph node metastasis, and recurrence.


We analyzed a total of 204 cases of papillary thyroid macrocarcinoma. Number, size and distance from the main tumor of the tumor sprouting were observed and analyzed with clinicopathologic characteristics.


Tumor sprouting was observed in 101 patients. Presence of tumor sprouting was significantly associated with positive resection margin (p=.002), lymphovascular invasion (p=.001), lymph node metastasis (p<.001), and recurrence (p=.004). Univariate analysis of recurrence-free survival revealed that tumor multiplicity (p=.037), positive resection margin (p=.007), lymphovascular invasion (p=.004), lymph node metastasis (p<.001), and tumor sprouting (p=.004) were poor prognostic factors. In multivariate analysis, positive resection margin was an independent poor prognostic factor of recurrence.


In conclusion, tumor sprouting is significantly correlated with lymph node metastasis and recurrence. Evaluation of tumor sprouting in PTC patients could be helpful in predicting tumor recurrence or lymph node metastasis.


Citations to this article as recorded by  
  • Peripheral Versus Intraparenchymal Papillary Thyroid Microcarcinoma: Different Morphologies and PD-L1 Expression
    Bozidar Kovacevic, Dragana Vucevic, Snezana Cerovic, Catarina Eloy
    Head and Neck Pathology.2022; 16(1): 200.     CrossRef
  • Lymphovascular invasion and risk of recurrence in papillary thyroid carcinoma
    Katy Wagner, Earl Abraham, Bryan Tran, David Roshan, James Wykes, Peter Campbell, Ardalan Ebrahimi
    ANZ Journal of Surgery.2020; 90(9): 1727.     CrossRef
  • The Predictors of Multicentricity in Well-Differentiated Thyroid Cancer
    Mohamed Hegazi, Waleed El Nahas, Mohamed Elmetwally, Amr Hassan, Waleed Gado , Islam Abdou, Ahmed Senbel, Mohamed Samir Abou-Sheishaa
    Journal of Analytical Oncology.2018; 7(4): 65.     CrossRef
  • Prognostic impact of vascular invasion in differentiated thyroid carcinoma: a systematic review and meta-analysis
    Huy Gia Vuong, Tetsuo Kondo, Uyen N P Duong, Thong Quang Pham, Naoki Oishi, Kunio Mochizuki, Tadao Nakazawa, Lewis Hassell, Ryohei Katoh
    European Journal of Endocrinology.2017; 177(2): 207.     CrossRef
  • Detection of Tumor Multifocality Is Important for Prediction of Tumor Recurrence in Papillary Thyroid Microcarcinoma: A Retrospective Study and Meta-Analysis
    Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang
    Journal of Pathology and Translational Medicine.2016; 50(4): 278.     CrossRef

JPTM : Journal of Pathology and Translational Medicine