ETA2022 Oral Presentations Oral Session 12: Nodules and Diagnostic (5 abstracts)
Autonomously functioning thyroid nodules present intermediate malignancy risk according to european thyroid imaging and reporting data system; a comprehensive clinical, cytological and molecular characterization
Aglaia Kyrilli 1 , nunzia tacelli 2 , Laetitia Lebrun 3 , Isabelle Salmon 4 , Gilles Russ 5 , Rodrigo Moreno-Reyes 6 & Bernard Corvilain 7
1Cliniques Universitaires de Bruxelles- Hôpital Erasme, Endocrinology, Brussels , Belgium; 2Cliniques Universitaires de Bruxelles – Hôpital Erasme, Radiology, Brussels, Belgium; 3Cliniques Universitaires de Bruxelles – Hôpital Erasme, Anatomopathology, Brussels, Belgium; 4Hôpital Erasme, Anatomie Pathologique, Brussels, Belgium; 5Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitie Salpetriere Hospital, Sorbonne University, Paris, France; 6Cliniques Universitaires de Bruxelles – Hôpital Erasme, Nuclear Medicine, Brussels, Belgium; 7Cliniques Universitaires de Bruxelles – Hôpital Erasme, Hub-Erasme University Hospital, Université Libre de Bruxelles, Endocrinology, Brussels, Belgium
Objectives: To systematically characterize autonomously functioning thyroid nodules (AFTN) by clinical, biological and imaging methods, cytology and histology when indicated.
Design: Prospective, single-center study conducted from March 2018 until September 2021, in 901 consecutive patients with 67 AFTN evaluated.
Methods: Enrolled patients underwent 99mTcO4 scintigraphy evaluation of thyroid function, ultrasound (US) using European Thyroid Imaging and Reporting Data System (EU-TIRADS), 123I scintigraphy in case of normal serum TSH, and fine needle aspiration (FNA) biopsy with molecular analysis and surgery when indicated.
Results: The median serum TSH of patients with AFTN evaluated was 0.41 (0.03-0.97) mU/l and more than half of the patients were euthyroid. The median AFTN size measured by US was 27.0 (21.1-35.0) mm. 28.3% of AFTN were classified as EUTIRADS score 3 and 72.7% as EUTIRADS score 4, indicating that the majority of AFTN had intermediate risk for malignancy according to US. Out of the 46 AFTN (31 with EU-TIRADS score 4 and 15 with score 3) subjected to cytological evaluation, 18 (39.2%) yielded indeterminate FNA results. DNA sequencing revealed THSR and GNAS mutations in 50% of the samples. No malignancy was detected at final histology (n=12), but one non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was observed.
Conclusions: AFTN frequently present with normal serum TSH, intermediate malignancy risk according to US, and yield indeterminate FNA results. No malignant AFTN was detected in this study, but further prospective studies addressing the risk of malignancy of AFTN as a primary outcome are needed.
Volume 84
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Endocrine Abstracts
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