TTN and neoplasm: We identified three evolutionary paths of gene mutations that could drive PTC progression across pathological stages: (i) recurrently mutated genes in all the stages, with BRAF driver gene showing a dominant role across all stages; (ii) some genes (NRAS and TG) mostly mutated in the early stages while disappearing in the advanced stages; (iii) other mutated genes (TTN, MUC16 and HRAS) emerged dominantly in advanced stages, thus suggesting their impact in the aggressive phenotype of this tumor.