ECEESPE2025 ePoster Presentations Thyroid (198 abstracts)
Outcomes of thyroid lobectomy in bethesda v and vi nodules: a clinical analysis
Miguel António Duarte 1 , Catarina Isabel Lopes 1 , Mariana de Griné Severino 1 , Marta Vaz Lopes 1 , José Vicente Rocha 1 , Carolina Peixe 1 , Mariana Lopes-Pinto 1 , Sónia do Vale 1,2 & Ema Lacerda Nobre 1,2
1Serviço de Endocrinologia, Diabetes e Metabolismo, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisboa, Portugal; 2Clínica Universitária de Endocrinologia, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
JOINT3630
Introduction: Thyroid nodules classified as Bethesda V (suspicious for malignancy) and Bethesda VI (malignant) present diagnostic and therapeutic challenges. Thyroid lobectomy is a possible surgical approach for these nodules, that may reduce morbidity, compared to total thyroidectomy, while ensuring oncologic safety. This study evaluates the efficacy and outcomes of lobectomy in patients with Bethesda V and VI cytopathology results, in order to optimize surgical decision-making and minimize complications.
Materials and Methods: We retrospectively revised and analysed the clinical data from seven patients with Bethesda V and VI nodules who underwent thyroid lobectomy in our hospital between 2022 and 2024, followed-up for ≥6 months.
Results: All seven patients were female, with a mean age at diagnosis of 59.6 years and a median follow-up time of 19 months. Only one patient had a personal history of cervical irradiation and there was no family history of thyroid malignancy. Four nodules were Bethesda VI and three were Bethesda V, all measuring less than 2 cm. Two patients presented with contralateral nodules (<1 cm). Papillary thyroid carcinoma was histologically confirmed in all cases, comprising six classic variants and one follicular variant. The mean tumor size was 9.3 mm and all tumors were unifocal, without evidence of angioinvasion, perineural invasion or lymph node metastasis. Microscopic extrathyroidal extension was noted in two patients. At six-month follow-up, five patients showed no evidence of disease, while two had an indeterminate response due to nonspecific imaging findings. These results remained consistent at the latest follow-up. No patients required completion thyroidectomy, and all are currently on levothyroxine to maintain target TSH levels (0.5-2 mU/l).
Conclusions: This study highlights the favourable outcomes of thyroid lobectomy in managing patients with Bethesda V and VI nodules, demonstrating its efficacy for small papillary thyroid carcinomas. With no cases requiring completion thyroidectomy and high remission rates, lobectomy proves to be a safe and effective approach in appropriately selected cases, minimizing patient morbidity.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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