Endocrine Abstracts

Background

The traditional cytology-based management of thyroid nodules often leads those with indeterminate cytology to unnecessary resection for diagnostic purposes. In an attempt to improve presurgical diagnosis, several molecular marker tests have been developed in the last decade.

Methods

The benefits and limitations of prospectively validated molecular marker tests in cytologically indeterminate thyroid nodules; and other risk stratification strategies that allow the individualization of management will be discussed.

Results

A selective use of molecular marker tests could be useful in the identification of low-risk nodules; but long-term follow-up of molecularly-benign/negative nodules is currently necessary. Furthermore, their predictive values need to be validated in specific clinical scenarios. Meanwhile, the sonographic pattern and some cytological features enable risk-stratification and can be used to individualize management in cytologically indeterminate thyroid nodules.

Conclusion

An individualized approach for cytologically indeterminate thyroid nodules is not only desirable but also possible through the integration of clinical, sonographic, and cytological features. Current molecular marker tests could be of use selectively; but their role in the evaluation of cytologically indeterminate thyroid nodules needs to be better defined.