ArticleGland surgery2026
Papillary thyroid carcinoma with fibromatosis/fasciitis-like stromal component is a rare subtype of papillary carcinoma with moderate aggressiveness: a single-center retrospective cross-sectional study of 725 patients.
Article in Gland surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Papillary thyroid carcinoma with fibromatosis/fasciitis-like stroma (PTC/WF/FLS) is a rare subtype with poorly defined clinical and biological behavior. We observed an increasing number of cases and a relatively high rate of capsular invasion, suggesting potential local recurrence and postoperative relapse, which warrant further investigation. The objective of this study is to delineate the invasive and metastatic capabilities of this subtype through the investigation of its clinicobiological parameters. Methods: According to the 2022 World Health Organization (WHO) Classification of Thyroid Tumors, 725 patients with thyroid cancer collected between 2017 and 2021 were classified into a PTC/WF/FLS observation group, high-risk group (HRG), and low-risk group (LRG). Age, sex, tumor location, lesion number, tumor size, family history of cancer, genetic mutations, and tumor microenvironment were compared among the three groups, and their effects on lymph node metastasis and local invasion of the capsule, blood vessels, and nerves were analyzed. Results: The PTC/WF/FLS, HRG, and LRG showed no significant differences in age, sex, tumor location, lesion number, genetic mutations, or tumor microenvironment. In early-stage disease (T1), the PTC/WF/FLS group had the highest capsular invasion rate compared with the HRG and LRG (16.28%, 5.53%, and 7.51%, respectively; P=0.003). The association with a family history of cancer was also higher in the PTC/WF/FLS group than in the HRG and LRG (9.24%, 4.91%, and 3.44%, respectively; P=0.04). Propensity-matched and stratified analyses showed that the VI-region lymph node metastasis rate in the PTC/WF/FLS group was intermediate between those in the HRG and LRG, although the between-group differences were not significant (P=0.10 and P=0.97, respectively). Conclusions: PTC/WF/FLS is a rare, moderately aggressive subtype of papillary carcinoma. It shows a strong tendency toward capsular invasion and lymphatic metastasis, even at an early stage (T1), which may increase the risk of early local recurrence and postoperative relapse.
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