Endocrine Abstracts

Background: The discovery of a thyroid nodule exposes the problem of the possibility of thyroid cancer. The difficulty of management of this situation is the fact that only the histopathological examination can confirm or refute the malignancy. Fine-needle aspiration (FNA) is used as a diagnostic tool to assess thyroid nodules. The purpose of our study is to correlate the clinical, ultasonographic, the FNA results and final pathology to determine the predictors of malignancy of thyroid nodules.

Patients and Methods: We conducted a retrospective study on 33 patients with thyroid nodule. Data were obtained for FNA diagnosis, demographics, findings on ultrasound, and histologic findings.

Results: The average age of our patients was 41.7years±15.6 SD with a female predominance (100%). Ultrasound findings were as follows: singles nodules, multinodular goiter (MNG), and multiple nodules in respectively 48.5, 39.4 and 12,1% of cases. Thyroid function tests prior to surgery were normal in all patients. Among the 33 patients, 7 (21.2%)have malignant tumors in histological findings: Two patients had signs of locoregional compression. A case of fixed nodule was noted and one patient had cervical lymphadenopathy. On ultrasonogrqphy: the average size of the nodules was 34.0±14.5 mm, three nodules were hypoechogenic, and 1 case of mixed vascularity was diagnosed. The FNA was benign in 90.9% of cases (n=30), and indeterminate in 9.1% (n=3). Of the 30 patients with a benign FNA result, 7 were found to have carcinoma on final pathology for 23.3% false negative rate and sensitivity of 76.7%. 1 patient were found to have incidental microcarcinoma which was located in the palpated lesion.

Conclusion: FNA biopsy is essential in the assessment and management of thyroid nodules. However, we report a high rate of malignancy among FNA diagnosed as benign lesions. This high rate of malignancy is the basis for our recommendation for a surgical approach for benign lesions.