Endocrine Abstracts

Introduction: The question of whether pregnancy has any impact on the prognosis of differentiated thyroid cancer diagnosed in pregnant women was addressed mainly in retrospective analyses, which showed no significant differences in overall and progression-free survival between women diagnosed during pregnancy in comparison to women whose thyroid cancer diagnosis was unrelated to pregnancy. Thus, following the recent guidelines, watchful waiting is the preferred option, and surgical intervention may be postponed to the postpartum period. Surgery may be considered in the second trimester if high-risk features are present or a significant tumor is observed.

Aim: The aim of this study is to analyze the dynamics of malignant thyroid nodules followed in pregnant women.

Methods: A retrospective analysis of a group of 75 women at a mean age of 30.9±4.8 years with suspected thyroid nodules detected during pregnancy. All patients underwent fine-needle aspiration biopsy (FNAB). The FNAB result was classified according to the Bethesda System for Reporting Thyroid Pathology. The diagnosis was confirmed by two independent pathologists. Only patients with the Bethesda V category (suspicious for malignancy) or Bethesda VI category (malignancy) were considered. Patients were followed by neck sonography (US) every 2-3 months until surgery. The median follow-up from the diagnosis to surgery or the last follow-up was 10.0 months (range 1.0-39.0).

Results: Papillary thyroid cancer (Bethesda VI) was diagnosed in 53 patients, whereas in the remaining 22 patients, the FNAB result was suspicious for papillary thyroid carcinoma (Bethesda V). The mean nodule diameter at the first US evaluation was 12±7.7 mm. Thirty-nine nodules were ≤10 mm in diameter. In 29 nodules, the tumor diameter ranged between 11 and 20mm. Only 7 nodules (9,3%) were stable during the whole follow-up in 65 (86.6%) patients. The nodule diameter increased in 9 (12%), while in one patient, the nodule dynamics could not be evaluated. Lymph node metastases were diagnosed at initial evaluation in 1 patient. Although in 55 patients (73.3%) thyroid nodules were diagnosed before 24 weeks of gestation, the majority of them chose watchful waiting. Only 2 women were operated on during pregnancy. Sixty-five (86.7%) underwent surgery after delivery. Histopathological data and outcomes will be presented during the congress.

Conclusions: Watchful waiting is a safe option for patients diagnosed with papillary thyroid carcinoma or suspicion of papillary thyroid carcinoma. However, careful monitoring should be considered to choose the most optimal time for surgery.