Endocrine Abstracts

Introduction: Thyroid nodules are a very common finding in sonographies (20–75% people). Criteria for clinical management and for cytological diagnosis (-Bethesda system) are well standardized. In spite of this, a gap of knowledge exists as far as management of Bethesda 4 is concerned.

Aim: Evaluate the clinical approach of Bethesda 4 (B4) result in a thyroid cytology.

Material and Methods: Retrospective study of thyroid nodules classified as B4 in FNA in our hospital between 2012 and 2018. Statistical analysis: SPSS v.22.0 (Student’ t-test to compare means and

Squared Chi/Fisher to proportions).

Results: 162 nodules classified as B4 in FNA. Mean age: 54.07 ± 14.62 years. 75.3% Women. 138 (85.2%) were surgically removed: 11.6% of them were part of a multinodular goitre; 55.8% follicular adenomas; 10.9% follicular carcinomas; 8.7% papillary carcinomas; 1.4% medullary carcinomas; 11.6% NIFTPs. In 24 cases there were not a surgical treatment: In 12 of them active surveillance was decided in accordance to patients’ preferences, in 10 of them surgical treatment was put off because of an intercurrent neoplasia and 1 patient died of an unrelated cause.

Conclusions: In our cohort, proportion of B4 thyroid nodules and carcinoma result after surgery doesn’t differ from previously published results. Although the use of this category seems correct, it gives rise to a surgical overtreatment in hyperplasic nodules.