*Response Options to Histologic Type

___ Papillary Carcinoma Variant, specify:

___ Classic (conventional)

___ Follicular variant, encapsulated /well demarcated, with tumor capsular invasion

___ Follicular variant, infiltrative

___ Tall cell variant

____Cribriform-morular variant

____Diffuse sclerosing variant

____Other variant (specify) 

___Follicular Carcinomas

___Minimally invasive

___Encapsulated angioinvasive

___Widely invasive

___Minimally invasive, oncocytic (Hurthle cell)

___Encapsulated angioinvasive, oncocytic (Hurthle cell)

___Widely invasive, oncocytic (Hurthle cell)

___Minimally invasive, other variant (specify)

___Encapsulated angioinvasive, other variant (specify)

___ Widely invasive, other variant (specify)   

___ Poorly differentiated thyroid carcinoma

___ Undifferentiated (anaplastic) carcinoma

       ____ Focal or minor component without extrathyroidal extension

       ____ Major component

       ____ Not otherwise specified

      Medullary carcinoma

      Other (specify)

      Carcinoma, type cannot be determined

**Extrathyroidal extension

Microscopic extrathyroidal extension that is not grossly evident is no longer a criterion for upstaging. The T stages, pT3b, pT4a, pT4b, are now defined by extrathyroidal extension into at least skeletal muscle, which then necessitates review of macroscopic, intraoperative, and radiologic findings. As such, a thorough gross examination and review of the operative and radiologic findings are now essentially required to document the “gross” extrathyroidal extension required to upstage a tumor.

___ Invading only strap muscles

___ Invading subcutaneous soft tissues, larynx, trachea, esophagus or recurrent laryngeal nerve

___ Invading prevertebral fascia or encasing the carotid artery or mediastinal vessels

***Specification of nodal levels (select all that apply)

____Level VI – perithyroidal, pretracheal, paratracheal and prelaryngeal/Delphian (central compartment dissection)

____Level VII (superior mediastinal lymph nodes)

____Level I-V (lateral neck dissection)

____Other (specify)

Endocrine

Staging

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