Endocrine Abstracts

Introduction: Epidemiological studies show that thyroid nodules (TN) are found on ultrasonography in 19-67% of patients, with a predominance in women, the elderly, and populations living in areas with insufficient iodine intake. Approximately 5-15% of nodules are malignant, of which 95% are well-differentiated thyroid carcinomas.

Material and methods: The medical history of 377 patients treated for thyroid carcinomas (TC) in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Endocrinology and Surgery departments from 2018 to 2022 were analyzed. The patient’s medical history, fine needle aspiration (FNA) of the TN cytology results and histological findings of operative material were interpreted. Calculations were performed using IBM SPSS Statistics 28.0 package.

Results: The study population consisted of 79% women and 21% men with an average age of 52.5±16.1 years. TN of 91% of patients were evaluated using EU-TIRADS scale. For 93% of patients FNA was performed before a thyroid surgery. EU-TIRADS median of TN, of which FNA were performed, was 5 (4-5). On average, FNA was performed 1, 16 times per patient. Median disease duration, counting from TN detection to surgery, was 8, 5 months. Cytological and histological concordance was observed in 93, 3% of cases, with a concerning 50% error rate in diagnosing anaplastic TC. The majority of patients (89, 9%) were diagnosed with papillary carcinoma, and the predominantly observed stage was pT1a (39, 4%). The total prevalence of TC is shown in Table 1. By ultrasound cancer metastases were identified in 17.1% of cases, although after surgical material examination metastases were observed in 29, 2% of cases with 90% being locoregional and 10% distant.

Conclusions: According to our study, FNA shows limitations in identifying anaplastic TC. Moreover, almost 30% of patients were diagnosed with metastases. It is essential to note that patients with TN must be strictly monitored, especially those who have suspicious TN.

Reference: 1. Haugen BR et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid: official journal of the American Thyroid Association [Internet]. 2016;26(1):1–133.