Endocrine Abstracts

Objectives: Gender has long been recognized as a significant epidemiological variable in the study of thyroid diseases. However, the modern approach of gender medicine introduces new perspectives to this field. The aim of this study was to investigate how gender influences the clinical presentation, volume changes and cytological features of benign thyroid nodules during follow-up

Methods: We conducted a retrospective analysis of 1010 patients (17.1% males and 82.9% females), diagnosed with benign nodular disease, with a median age at diagnosis of 56 years. All patients underwent re-evaluation at a median follow-up period of 3.8 years.

Results: The mean diameter of nodules was 21.4±9.3 mm in females and 25.6±12.1 mm in males (P < 0.0001). The mean volume of nodules was 4.1±6.6 ml in females and 9.0±14.2 ml (P < 0.001). The rate of thyroid nodules with diameter >4 cm was significantly higher in males (13.3%) than in females (5.5%) (P = 0.002). No differences were observed between males and females regarding ATA US risk class (P = 0.77) and age at diagnosis (P = 0.34). At a median follow-up of 3.8 years, in both females and males the nodule volume was significantly higher than that observed at the diagnosis (P < 0.0001 and P < 0.0001, respectively). The rate of patients with nodule volume increased, according to ATA criteria, was 38.1% in males and 47.0% in females (P = 0.02). In females group the rate of nodules with increased of volume was significantly higher in female younger than 45 years (106/200, 53% versus 288/636, 45.2%, P = 0.01). On the contrary no correlation between age and the risk of increased volume was observed in males (P = 0.36). At FNAC repetition (3.8 years after diagnosis) the change in cytological features (from Thy 2 to Thy3-4-5) was observed in 3.3% of females (28/837) and in 3.5% of males (6/173) without differences (P = 1.0).

Conclusions: These findings suggest that gender influences not only the initial presentation but also the subsequent evolution of benign thyroid nodules. Further studies exploring the underlying mechanisms driving these gender-specific differences are warranted to optimize patient management strategies tailored to individual needs.