Endocrine Abstracts

Introduction: As our population ages, more people are diagnosed with thyroid nodules (TN). The prevalence of TN varies by country. In this study, we would like to present the evaluation of benign thyroid nodules in Lithuania in 2018 – 2022.

Material and methods: The medical history of 719 patients treated for thyroid nodules (TN) 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 TN cytology results, and histological findings of operative material were interpreted. Calculations were performed using the IBM SPSS Statistics 28.0 package.

Results: The study population comprised 82, 9% women and 17, 1% men with a median age of 54 [10-90] years. We found a slight decrease in cases compared to 2018 (177) and 2022 (123). More than half (53%) of patients’ TN were evaluated EU-TIRADS score 3, 18% EU-TIRADS score 4 and 5. Almost half of the patients (52%) had nodules larger than 3 cm. 54% of patients had nodules only in one thyroid gland lobe. There was no statistically significant age difference between genders at the time of the first TN finding (P=0, 058). Women were observed for a statistically longer time before surgery (P<0.001) with a median of 30 [1 - 636)] months. 26% of patients were discussed by a multidisciplinary council before surgery. The most common reason for thyroid surgeries (48%) was shortness of breath or difficulties swallowing. Other reasons: thyrotoxicosis (31%), malignant nodule was suspected (14%), TN were found after parathyroidectomy (4%), cosmetic defect (3%). Due to malignancy being suspected by ultrasound, 33% of patients had a fine needle aspiration biopsy (FNA) before thyroid surgery. Unfortunately, the results of cytology and surgery material’s histology differed in 27, 27% of cases, when FNA showed malignancy, but histology showed benign lesions.

Conclussion: The main clinical concern is to exclude malignant nodules and avoid overdiagnosis, because misdiagnosis can decrease the patient‘s quality of life. Although TN has a low risk of malignancy and patients should continue ongoing surveillance through physical examination and periodic ultrasound evaluations.

References: 1. Holt EH. Current Evaluation of Thyroid Nodules. Medical Clinics of North America. 2021 Nov;105(6):1017–31. 2. Uppal N, Collins R, James B. Thyroid nodules: Global, economic, and personal burdens. Frontiers in Endocrinology. 2023 Jan 23;14.