Endocrine Abstracts

Objective: The recommendations for action in a Bethesda category III are to repeat the cytology or to perform molecular tests, and if these are inconclusive, surveillance or surgical indication may be maintained, depending on the risk factors, ultrasound characteristics of the nodule and patient preference. In case of category IV of Bethesda, the recommendation is the surgery. The objective of this study was to evaluate the impact of age, gender and nodule size on the incidence of malignant lesions in patients with thyroid nodules with Bethesda III and IV classification.

Material and methods: Retrospective observational study of patients undergoing Total Thyroidectomy between July 2014 and June 2016. Totalizations were excluded. Descriptive analysis and statistical treatment with SPSS 20.

Results: Four hundred ninety two patients were submitted to Total Thyroidectomy after their presentation at the Multidisciplinary Thyroid Group consultation. The mean age of the patients was 54.6 years, being 82.7% female. Bethesda III was indicated in 52 patients, and Bethesda IV in 125 patients. In category III, in seven patients (13.5%) the histology revealed to be a malignant lesion, 71.4% female, mainly in the 5th decade of life; the majority of patients were T1b. In category IV, in 20 patients (16%) the histology revealed a malignant lesion, 65% female, mainly in the 6th decade of life; the majority of patients were T1b.

Conclusions: In our series, 13.5 and 16% of patients with a category III and IV Bethesda surgical indications were found to be malignant lesions, respectively, according to the literature (5–15% for Bethesda III, 15–30% for Bethesda IV). It was not possible to find a statistically significant difference between the variables tumor size, age group of patients and gender.