Characteristics of bethesda 3 and 4 thyroid nodules: bethesda grey area

Nadia Salem; Dorra Chiboub; Amal Sifaoui; Nadia Romdhane; Imen Zoghlami; Safa Nefzaoui; Emna Rejeb; Asma Ayadi; Ines Hariga; Mbarek Chiraz

doi:10.1530/endoabs.101.PS3-22-10

PS3-22-10

Prev Next

Section Contents Cite

Endocrine Abstracts (2024) 101 PS3-22-10 | DOI: 10.1530/endoabs.101.PS3-22-10

ETA2024 Poster Presentations Diagnosis of thyroid cancer-2 (11 abstracts)

Characteristics of bethesda 3 and 4 thyroid nodules: bethesda grey area

Nadia Salem ¹ , Dorra Chiboub ² , Amal Sifaoui ¹ , Nadia Romdhane ¹ , Imen Zoghlami ¹ , Safa Nefzaoui ¹ , Emna Rejeb ¹ , Asma Ayadi ¹ , Ines Hariga ¹ & Mbarek Chiraz ¹

Views

Author affiliations

¹Habib Thameur Hospital; ²Habib Thameur Hospital, Ent Department, Tunis Montfleury, Tunisia

Aim: To investigate the clinical, paraclinical and histological characteristics of Bethesda 3 and 4 nodules and determine their malignancy rate.

Methods: We conducted a retrospective descriptive study including 52 patients who underwent surgery for Bethesda class 3 and 4 thyroid nodules at the ENT department over a 7-year period (2016-2022).

Results: The mean age of our patients was 51 years, with a ratio of 0.13. The most common presenting symptom was an anterior neck swelling in 34 cases. Cervical ultrasound showed a solitary nodule in 60% of cases and multiple nodules in 40% of cases. The most suspicious nodule was subjected to ultrasound guided fine-needle aspiration and an EU-TIRADS classification ranging from 3 to 5. Cytological examination classified the samples as Bethesda 3 in 59.6% and Bethesda 4 in 40.4%. Total thyroidectomy was initially indicated in 30.7% of cases, while lobectomy was performed in 69.3% of cases. Completion thyroidectomy was performed in 15 cases. Lymph node dissection was indicated for 32 patients. The final histological examination confirmed malignancy in 28.8% of cases, accounting for 33.3% of patients classified as Bethesda 3 and 33.3% of patients classified as Bethesda 4. Incidental papillary microcarcinomas were found in 21% of cases, and lymph node metastasis in 9.6% of cases.

Conclusion: The Bethesda classification was introduced to standardize the cytological evaluation of thyroid nodules and guide therapeutic decisions. The significant variability in the malignancy rate of Bethesda class 3 and 4 nodules necessitates the establishment of precise strategies to optimize their management.