Patient Question:Disease:Microscopic papillary thyroid cancer Description:Ultrasound shows a single nodule, less than 1 cm, elliptical shape, left upper pole, no abnormal lymph, cytocentesis suggests a tendency to papillary thyroid cancer, understanding that microscopic thyroid cancer is mild and may not develop in the long term, can we not operate first, follow up closely and wait for changes before further treatment? Help wanted:Ultrasound shows a single nodule, less than 1 cm, left upper pole, no abnormal lymph, cell puncture suggests a tendency to papillary thyroid carcinoma, understanding that microscopic carcinoma is mild and may not develop in the long term, can we not operate first, follow up closely and wait for changes before further treatment? Department of Surgery, Ruijin Hospital Luwan Branch Department of Surgery, Fudan University Cancer Hospital Head and Neck Surgery Wang Yu replied: Hello, for papillary microcarcinoma, detailed examination is needed, and for those suggesting invasion and metastasis, surgery is definitely needed. For the treatment of papillary thyroid microcarcinoma without these signs there is a certain debate. Statistically the postoperative pathology suggestive of metastasis in patients with cN0 (45%) is indeed lower than that of papillary thyroid carcinoma larger than 1 cm (75%), but it still should not be underestimated. There is no clear and feasible clinical means to identify this group of patients. Therefore, the current advice given by clinicians is still to recommend surgery once thyroid cancer is considered at diagnosis. Of course, the patient has treatment options and can refuse surgery. Close follow-up is also requested in this case.