ABSTRACT
Background:Thisstudy investigated the utility of the Sonographic pattern "BlackInk" with BRAF mutation testing of thyroid fine-need leaspi rationcy to logy specimens for the risk papil larythy roidmic rocarcinoma(PTMC).Case Presentation: Wed escribea caseofa41-year-old Caucasian woman af fected by ault rason ography “BlackInk”papillarythyroidmicrocarcinoma(PTMC)oftheleftlobeofthethyroidglandwithverytinysize(Ø0.4cm).Thecharacteristics,withtheDiagnosticImagingusingUltrasonography(US),SuperbMicro-VascularImaging(SMI),fine-needle-aspirationcytology(FNAC)andmutationanalysisareherediscussed.Therearemoreraresubtypesofthyroidcanceraspapillarymicrocarcinoma"BlackInk"thatevenifsmall,areinvasiveandthereiswhytheneedtoearlydiagnosistoavoidtheiraggressivebehaviorisneeded.Nowadays,focusingonthesize,thecut-offfornon-occulttinytumorshasdroppedto0.3cm.Thisvalueisofgreatrelevance.Conclusion:Ultrasonography,FNACandBRAFmolecularstudyhaveproventobethemostsensitivediagnosticcombinationfortheearlydetectionofthyroidcancer.Despitethesizeofthismicro-lesion,theBlackInkultrasonographicpatternassociatedwithmalignantcytologyatFNACrepresentsanimportantbiologicalriskfactorandcouldstillbeapredictorofthePTMCandriskfornecklymphnodemetastases