ECEESPE2025 Poster Presentations Thyroid (141 abstracts)
Atypia of undetermined significance (AUS) in pediatric thyroid nodules: Surgery after first fine needle aspiration (FNA) or follow-up?
Yaprak Ece Yola Atalah 1 , Dogu Vuralli Bakkaloglu 2 , Yasemin Ozluk 2 , Yalin Iscan 3 , Ismail Cem Sormaz 3 , Nihat Aksakal 3 , Yasemin Giles Senyurek 3 , Asli Derya Kardelen Al 1 , Melek Yildiz 1 , Firdevs Bas 1 & Sukran Poyrazoglu 1
1Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Türkiye; 2Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Türkiye; 3Istanbul University, Istanbul Faculty of Medicine, Department of Endocrine Surgery, Istanbul, Türkiye
JOINT1965
Introduction: The subsequent management of AUS in pediatric FNAs remains a controversial issue. While the 2015 American Thyroid Association (ATA) guideline recommends surgery after the initial AUS diagnosis, the 2022 European Thyroid Association (ETA) guideline advocates for performing a second FNA after 6 months. In the literature, the malignancy rates of pediatric patients diagnosed with AUS in FNAs present contradictory results. We aimed to investigate the follow-up and postoperative data of patients with AUS in FNA.
Methods: The medical records of 54 patients (F/M:36/19) with FNAs classified as AUS were reviewed retrospectively. Potential risk factors for malignancy predisposition in patients diagnosed with AUS and their follow-up were retrospectively examined (age, family history, previous diseases, nodule characteristics on ultrasonography).
Results: The mean age of patients was 14.1± 3.2 (5.7–21). Of the 54 patients, 49 underwent definitive surgery. Twenty-nine patients underwent surgery following the initial FNA, while 20 patients have surgery after subsequent FNA. The malignancy rate was 48.3% (14/29) after single AUS and 75% (15/20) after repeated FNA. Risk factors for thyroid cancer were similar in both groups. No specific ultrasound findings indicative of malignancy was identified in the patients with AUS having malignancy. Patients with malignancy after single FNA of AUS were operated within 0.18±0.08 years. However, patients with the second FNA diagnosis were operated within 1.2±1.3 years, (P<0.05).
Conclusion: Our study revealed that the rate of malignancy is high in pediatric patients with AUS. However, performing surgery after first AUS leads to unnecessary surgery in 51.7% of patients. To avoid unnecessary surgery or delayed diagnosis, molecular analysis and cytopathologic atypia subclassification should be performed in management of AUS in pediatric patients.
Volume 110
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Endocrine Abstracts
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