Papillary thyroid carcinoma in young patients in Tunisia: clinico-pathological characterization and treatment response

Introduction: This study aims to investigate factors influencing survival in patients under 40 years old. Methods: A retrospective, study conducted at the Salah Azaiez Institute in Tunis. Results: Forty patients were selected. The average age was 26.57 years with a sex ratio of 0.14. Multifocality was observed in 50% of cases and some tumors had extra-thyroid extension (12%). Papillary architecture was present in the majority of cases (82%). CPTC was the most common histological type (90%). Coexistence of different nuclear atypia was observed in 32% of cases. The majority of carcinomas (85%) had a low mitotic count (<5mitosis/10CFG). Tumor necrosis was observed in 20% of cases. Angioinvasion was observed in 20% of cases. Lymph node metastases were present in 57% of patients. Nine patients had relapsed (between 2 and 14 months). Analysis of clinical and epidemiological factors showed a trend towards better survival in female patients and patients under 27 years old, with p-values close to significance, respectively (p=0.08, p=0.09). Conclusions: The histopathological prognostic factors recently put forth by the new WHO classification in 2022 may not be as applicable to patients under 40 years old.