ECE2016 Eposter Presentations Thyroid (non-cancer) (120 abstracts)
Hemithyroidectomy seems to be a reasonable initial surgical approach for patients with cytologically Bethesda Category III (AUS/FLUS) thyroid nodules
Cuneyt Bilginer 1 , Didem Ozdemir 2 , Oya Topaloglu 2 , Cevdet Aydin 2 , Gurkan Dumlu 3 , Hayriye Dogan 4 , Reyhan Ersoy 2 & Bekir Cakir 2
1Atatürk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey; 2Ankara Yildirim Beyazit University School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey; 3Ankara Yildirim Beyazit University School of Medicine, Department of General Surgery, Ankara, Turkey; 4Atatürk Education and Research Hospital, Department of Pathology, Ankara, Turkey.
Introduction: Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) termed as Bethesda Category III constitute 15–30% of thyroid cytology. However, the risk of malignancy in this heterogenous category is estimated as 5–15%. The recent studies has been reported the malignancy rate in the wide range of 6–48%. This causes surgical approach variability between different centers. We aimed to evaluate the initial malignancy rate, indication of complementary thyroidectomy, and malignancy rate in contralateral thyroid lobe in patients with AUS/FLUS thyroid nodules who underwent hemithyroidectomy.
Methods: We reviewed the medical records of 47 (7 male, 40 female; mean aged 40.3±13.3) patients with cytologically 48 AUS/FLUS nodules who underwent hemithyroidectomy operation at our institution. The patients with tumor size <10 mm (microcarcinoma), papillary carcinoma with follicular, oncocytic, clear cell variants were accepted as low risk group. Patients with tumor size ≥10 mm, papillary carcinoma with columnar, tall cell, insular, solid, diffuse sclerosing variants, follicular carcinoma with widely invasive variant were accepted as high risk group.
Results: The preoperative cytology was evaluated as AUS in 32 (66.7%) nodules and FLUS in 16 (33.3%) nodules. Histopathology was reported as benign in 34 (72.3%) patients and as malignant in 13 (27.7%) patients. However, 9 (19.2%) patients was in high risk group, 4 (8.5%) patients was in low risk group. Of 13 patients, complementary thyroidectomy was performed in 11 (23.4%) patients. Of 11 patients who underwent contralateral lobectomy, 9 (81.8%) patients had benign histopathology and 2 (18.2%) patients had malignant histopathology.
Discussion: Malignancy rate in patients with AUS/FLUS nodules who underwent hemithyroidectomy was found as 27.7%. Moreover, malignancy rate in contralateral lobe was demonstrated as 18.2%. It seems that lobectomy is a reasonable initial surgical approach for these patients. Further studies with larger sample size are needed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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