Incidental thyroid carcinoma in patients with TIR1, TIR2 and TIR3 FNA


COD: 2808_09_02_2018_AOP Categorie: ,

Angela Pezzolla, Serafina Lattarulo, Graziana Barile, Daniele Paradies, Giuseppe Pentassuglia,
Francesco Prete, Rinaldo Marzaioli

Ann Ital Chir, Digital Edition 2018; 7
Epub Ahead of Print – February 31

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AIM: The aim of our study was to evaluate the presence of incidental differentiated thyroid carcinomas, at final histological
examination, in patients undergoing thyroidectomy or lobectomy for presumed benign pathology or in those with cytological
diagnosis of indeterminate nodules (TIR3).
MATERIAL OF STUDY: 457 patients who underwent surgery for benign disease and 179 patients with indeterminate FNA
were included in our study.
RESULTS: 77 out of 457 patients had the diagnosis of differentiated thyroid carcinoma. 29 out of 179 patients had the
same diagnosis as previous ones, but not on the undetermined FNA nodule. In the most of the cases, the istotype was
follicular variant of papillary carcinoma.
DISCUSSION: The incidence of incidental carcinomas, approximately the same in the two groups of patients, respectively
16.8% and 16.2%, shows that there is still a group of patients with benign thyroid disease escaping a careful ultrasound
evaluation and therefore a targeted FNA. Even in patients with indeterminate cytology, the presence of an incidental
carcinoma suggests that on the one hand there has been an overestimation and on the other a non-recognition of the
really suspect nodule. Although in most cases it is a microcarcinoma, we must not overlook the presence of many tumors
at stage T3.
CONCLUSIONS: Surely the analysis of the set of risk factors with a wider application of molecular biology surveys will
in the future lead to better selection of patients to undergo surgery sooner than those that can be followed in follow up
even for a longer period of time.