Annexin A5 showed upregulation in papillary thyroid carcinoma. Cervical lymph node metastasis is also a common feature of papillary thyroid carcinoma. Less common types include mucinous cystic neoplasm and intraductal papillary biliary neoplasm. Cervical lymph nodes become palpable in papillary carcinoma even when the primary tumor is unpalpable. They may appear in papillary thyroid carcinoma. Lymphatic spread is most common in papillary carcinoma. Rupture of a papillary muscle will cause acute mitral regurgitation. Analgesic nephropathy is a common cause of renal papillary necrosis. The reticular region is usually much thicker than the overlying papillary dermis. Bilateral hydronephrosis and renal papillary necrosis have also been reported in some cases. The cystic spaces have epithelium referred to as papillary infoldings that protrude into them. Hence, women have higher chance of getting inflammatory papillary hyperplasia. Thyroglobulin can be used as a tumor marker for well-differentiated papillary thyroid cancer. Surgery remains the mainstay of treatment for papillary thyroid cancer. Cases of papillary thyroid cancer have been reported as well.