An Indeterminate for Malignancy FNA Report Does Not Increase the Surgical Risk of Incidental Thyroid Carcinoma

Incidental thyroid carcinomas (ITCs) are a fairly frequent finding in daily routine practice, with papillary thyroid microcarcinoma being the most frequent entity. In our work, we isolated incidental cases arising in thyroids removed for other cytologically indeterminate and histologically benign no...

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Bibliographic Details
Published in:Cancers 2022-11, Vol.14 (21), p.5427
Main Authors: Seminati, Davide, Mane, Eltjona, Ceola, Stefano, Casati, Gabriele, Putignano, Pietro, Garancini, Mattia, Gatti, Andrea, Leni, Davide, Pincelli, Angela Ida, Fusco, Nicola, L'Imperio, Vincenzo, Pagni, Fabio
Format: Article
Language:English
Subjects:
Biopsy, Needle
Cancer
Carcinoma
Complications and side effects
Diagnosis
Graves disease
Malignancy
Metastasis
Methods
Nodules
Patients
Risk factors
Statistical analysis
Statistics
Thyroid cancer
Thyroid carcinoma
Thyroidectomy
Tumors
Variables
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Summary:Incidental thyroid carcinomas (ITCs) are a fairly frequent finding in daily routine practice, with papillary thyroid microcarcinoma being the most frequent entity. In our work, we isolated incidental cases arising in thyroids removed for other cytologically indeterminate and histologically benign nodules. We retrospectively retrieved cases with available thyroid Fine Needle Aspiration (FNA, 3270 cases), selecting those with an indeterminate cytological diagnosis (Bethesda classes III−IV, 652 cases). Subsequently, we restricted the analysis to surgically treated patients (163 cases) finding an incidental thyroid carcinoma in 22 of them. We found a 13.5% ITC rate, with ITCs representing 46.8% of all cancer histologically diagnosed in this indeterminate setting. Patients received a cytological diagnosis of Bethesda class III and IV in 41% and 59% of cases, respectively. All ITC cases turned out to be papillary thyroid microcarcinomas; 36% of cases were multifocal, with foci bilaterally detected in 50% of cases. We found an overall ITC rate concordant with the literature and with our previous findings. The assignment of an indeterminate category to FNA did not increase the risk of ITCs in our cohort. Rather, a strong statistical significance (p < 0.01) was found comparing the larger size of nodules that underwent FNA and the smaller size of their corresponding ITC nodule.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14215427