Abstract: To investigate the biological characteristics and management of papillary thyroid carcinomas ( PTCs ) and examine the BRAFV600E mutational status of individual tumor foci to determine whether multifocal PTCs arise from the intrathyroidal spread of a single carcinoma or from independent primary tumors. Methods: A retrospective analysis of 86 patients with pathologically confirmed progressive multifocal PTC and who underwent surgery was performed. Analysis results were compared with 282 cases of solitary lesions of PTC to determine the clinical biological characteristics of multifocal PTCs. The BRAFV600E mutational status of lesions was also analyzed. Results: Lymph node metastasis and vascular invasion occurred more frequently in multifocal PTCs than in solitary PTCs. No obvious differences between number of foci in LN-metastasis, extrathyroidal invasion, history of radiation, and microcarcinoma were observed among all the tumors studied. As well, no difference was observed between the distant metastasis and 10-year survival rates of solitary PTCs and multifocal PTCs. The heterogeneous distribution of BRAF mutations suggests that discrete tumor foci in multifocal PTCs occur as independent tumors. Conclusion: PTCs often present as multifocal tumors, which are associated with elevated risks of lymph node and distant metastases. The BRAFV600E mutational status of multifocal PTCs must be considered in the design of targeted therapeutic approaches using BRAF pathway inhibitors.