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Endocrine Abstracts (2022) 84 PS2-10-94 | DOI: 10.1530/endoabs.84.PS2-10-94

ETA2022 Poster Presentations Nodules & Cancer (10 abstracts)

Follow-up and incidence of malignancy in eu-tirads 3 nodules with indication of fine needle aspiration cytology. a single-center descriptive study

Carlien de Herdt 1 , Frida Peiffer 1 , Simon Nicolay 2 , Frank Delrue 2 , Patrick Pauwels 3 , Dirk Ysebaert 4 , Kathleen De Greef 5 & Christophe De Block 1

1Antwerp University Hospital, Department of Endocrinology-Diabetology-Metabolism, Antwerp, Belgium; 2Antwerp University Hospital, Department of Radiology, Antwerp, Belgium; 3Antwerp University Hospital, Department of Anatomopathology, Antwerp, Belgium; 4Antwerp University Hospital, Department of Hepatobiliary, Endocrine and Transplantation Surgery,, Antwerp, Belgium; 5Antwerp University Hospital, Department of Hepatobiliary, Endocrine and Transplantation Surgery, Antwerp, Belgium

Background: Current guidelines recommend repeat evaluation of a benign thyroid nodule after 1 to 2 years, which is only based on expert opinion. Objective data are needed to evaluate this recommendation.

Methods: This is a retrospective, descriptive study to describe the follow-up and incidence of malignancy in EU-TIRADS 3 nodules for which a fine needle aspiration cytology (FNAC) was indicated between 2017 and 2022. PET-positive thyroid nodules and thyroid nodules of which FNAC was indeterminate (Bethesda 1) were excluded.

Results: In total, 112 EU-TIRADS 3 nodules were included with a mean diameter of 3.17 ± 1.16 cm. Mean age of the study population was 54 ± 15 years with a female/ male ratio of 2.39. FNAC showed the following results; Bethesda 2 (97 nodules, 86.6%), Bethesda 3 (10 nodules, 8.9%), Bethesda 4 (4 nodules, 3.6%), Bethesda 5 (1 nodule, 0.9%), Bethesda 6 (no nodule). Of the 97 cases with Bethesda 2 classification, 13 cases underwent a total or hemithyroidectomy, 34 cases were followed for a median time of 24 (12-38) months and 50 cases were lost to follow-up. FNAC was repeated in 16 of the 34 cases which were in follow-up with the following results: Bethesda 1 (3 nodules, 18.8%), Bethesda 2 (11 nodules, 68.8%), Bethesda 3 (no nodule), Bethesda 4 (1 nodule, 6.3%), Bethesda 5 (1 nodule, 6.3%). The 2 nodules in which the repeat FNAC showed Bethesda 4 and 5 were resected and were benign. Anatomopathological examination of the 13 resected thyroid nodules with Bethesda 2 showed a malignancy in 2 cases of which one with distant metastasis. Of the 10 nodules with Bethesda 3, 5 underwent a thyroidectomy and all were benign. Of the 4 nodules with Bethesda 4, 3 underwent a thyroidectomy of which one nodule was malignant. The one case with Bethesda 5 underwent a thyroidectomy and showed a benign nodule.

Conclusion: In our single-center sample of EU-TIRADS 3 nodules only 3 (2.7%) cases had a pathology proven malignancy which is consistent to the given range described in the EU-TIRADS guidelines (2-4%). However, in 2 out of the 3 malignant thyroid nodules FNAC was benign (Bethesda 2). In the follow-up of 34 EU-TIRADS 3 nodules with Bethesda 2, 16 underwent a repeat FNAC of which 2 revealed a higher Bethesda classification which were eventually found to be benign on anatomic pathological examination.

Volume 84

44th Annual Meeting of the European Thyroid Association (ETA) 2022

Brussels, Belgium
10 Sep 2022 - 13 Sep 2022

European Thyroid Association 

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