General Characteristics of Papillary Thyroid Cancer Among Adolescents and Young Adults: A Single Large Center Experience

Background: Papillary thyroid cancer (PTC) incidence is rising, particularly among Adolescents and Young Adults (AYA, 15–39 years). However, data on PTC characteristics in the AYA population, especially from the Middle East, remain limited. This study aims to describe the clinicopathological features of PTC in AYA patients treated at a large tertiary center in Qatar. Methods: A retrospective chart review was conducted for AYA patients diagnosed with PTC between May 2015 and December 2020 at Hamad General Hospital, Qatar. Data on demographics, tumor characteristics, histopathology, staging, risk stratification, and treatment were extracted and analyzed. We stratified the cohort based on sex. Results: We studied 326 AYA patients (mean age 33.0 ± 5.2 years); the majority were females (72.7%) and were mostly of Asian origin (51.5%). Most patients underwent total thyroidectomy (77.6%), while 22.4% underwent partial thyroidectomy. Histologically, classic PTC was most common (83.38%), followed by the follicular variant (16.00%). Capsule invasion occurred in 21.04%, vascular invasion in 11.76%, and lymphatic invasion in 14.38%. Most patients were at low ATA risk (68.61%), with intermediate (20.06%) and high risk (11.33%) less common. Distant metastases were rare (0.3%), and 59.1% received Radioactive iodine (RAI). Compared to females, males had larger tumors (mean 2.65 cm vs. 2.01 cm, p = 0.0009), higher rates of vascular invasion (22.4% vs. 7.7%, p < 0.001), affected lymph nodes (mean 4.2 vs. 2.4, p = 0.0223), and ATA high-risk proportions (23.5% vs. 7.0%, p < 0.001). Conclusions: This study provides the first detailed characterization of PTC in AYA patients from Qatar. While confirming female predominance, males exhibited more aggressive features (larger tumors, higher LN involvement, and ATA risk). These findings emphasize the need to consider gender-specific differences in managing PTC within the AYA population.