Endocrine Abstracts

Our study aim is to find out the frequency of misdiagnosing destructive focal lesions caused by subacute thyroiditis as thyroid cancer.

Methods and Results: The study was conducted at the Armenian American Wellness Center in 2023-2024. Thirty-four patients aged between 30-40 years participated in the study. All patients presented with TI-RADS4 nodules detected on ultrasound and were referred for fine needle aspiration (FNA) by the radiologist. An endocrinologist was consulted before the FNA was performed. After a detailed physical examination and collection of medical history, it was discovered that 16 of the patients (47%) had neck pain and a history of viral infection. In the 16 patients mentioned above (47%), anti-inflammatory treatment with steroid anti-inflammatory drugs was prescribed, and FNA was delayed. After two months, the ultrasound was repeated, and the findings were recorded. As a result, in 11 of 16 patients (68.75%), the inflammatory destructive foci were absorbed, leading to qualitative changes observed on ultrasound as TI-RADS 2-3. A total of 34 patients with TI-RADS 4 nodules were included in the study. Among them,18 underwent FNA, while for 16 patients, close observation was chosen. After two months, ultrasound assessments revealed that 5 out of the 16 patients showed TI-RADS 4, prompting FNA, while 11 out of the 16 patients presented with TIRADS 2-3, leading to the decision to defer FNA.

Conclusions: Therefore, if the thyroid ultrasound shows a TI-RADS 4 pattern and there is pain in the neck, elevated C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), it is recommended to start anti-inflammatory treatment and subsequently reassess the condition of the thyroid nodule.