scholarly journals Tumor Size and Age Predict the Risk of Malignancy in Hürthle Cell Neoplasm of the Thyroid and Can Therefore Guide the Extent of Initial Thyroid Surgery

Thyroid ◽  
2010 ◽  
Vol 20 (11) ◽  
pp. 1229-1234 ◽  
Author(s):  
Tae Hyuk Kim ◽  
Jung Ah Lim ◽  
Hwa Young Ahn ◽  
Eun Kyung Lee ◽  
Hye Sook Min ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Tumor Size ◽  
Hürthle Cell ◽  
Cell Neoplasm ◽  
Risk Of Malignancy

Should “Indeterminate” Diagnoses Be Used for Thyroid Fine-Needle Aspirates of Nodules Smaller Than 1 cm?

2013 ◽  
Vol 137 (11) ◽  
pp. 1627-1629 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Edwin W. Gould
Keyword(s):  
Papillary Carcinoma ◽  
Follicular Cells ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell ◽  
Cell Neoplasm ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
The Bethesda System ◽  
Undetermined Significance

Context.—The Bethesda System for thyroid fine-needle aspirates does not account for the size of the lesion that is aspirated. Objective.—To determine whether the size of the lesion would be helpful in order to reduce indeterminate thyroid aspirations. Design.—We correlated the results of all thyroid aspirations and surgical resection for the last 16 years at our institutions. Results.—A total of 9080 cases were aspirated and 1393 resections were performed. Of those resected, a total of 236 (17%) were classified as atypical follicular cells of undetermined significance, and 256 (18%) were classified as suspicious for a follicular/Hürthle cell neoplasm. A total of 52 incidental papillary carcinomas were identified in these indeterminate cases at resection (52 of 492; 11%). Thirty-seven (16%) atypical follicular cells of undetermined significance cases and 21 (8%) suspicious for a follicular/Hürthle cell neoplasm cases were for nodules smaller than 1 cm in diameter. When cases subtyped as atypical, a papillary carcinoma cannot be ruled out, were removed (13 cases), the remaining 24 and 21 aspirates identified 3 tumors each (13% and 14%), all papillary carcinomas. Together, the incidence of identified carcinomas was not significantly different than that of incidental carcinomas (13% versus 11%, P = .48). The rate of identified carcinomas was significantly less than for similar indeterminate cases smaller than 1 cm (excluding cases of atypical, papillary carcinoma cannot be ruled out) (88 of 330 cases; 27%; P = .05). Conclusions.—For nodules smaller than 1 cm in our series, indeterminate aspirates without features of papillary carcinomas have the same risk of malignancy as benign aspirates.

scholarly journals Thyroid and Molecular Testing. Advances in Thyroid Molecular Cytopathology

2021 ◽  
Vol 2 (2) ◽  
pp. 77-92
Author(s):  
Esther Diana Rossi ◽  
Philippe Vielh
Keyword(s):  
Thyroid Nodules ◽  
Adult Population ◽  
Needle Aspiration ◽  
Common Finding ◽  
Molecular Testing ◽  
Additional Tool ◽  
Thyroid Cytology ◽  
Hürthle Cell ◽  
Cell Neoplasm ◽  
Undetermined Significance

Thyroid nodules are a common finding in the adult population including the fact that more than 50% of individuals, over the age of 60, have thyroid nodules. The majority have been mostly detected with ultrasonography and 10% by palpation. The majority of these nodules are benign, whereas 5–15% of them are malignant. The pre-operative diagnosis of cancer is a critical challenge in order to ensure that each patient can be treated with the best tailored management with a reduction of unnecessary surgery for benign lesions. Fine needle aspiration cytology (FNAC) represents the first and most important diagnostic tool for the evaluation of thyroid lesions. According to the literature, FNAC is able to render a conclusive diagnosis in up to 70–80% of all cases. For the remaining 20–30% of nodules, cytological diagnoses fall into the category of indeterminate lesions mostly due to the lack of specific morphological features. According to the Bethesda system for reporting thyroid cytopathology (TBSRTC), indeterminate lesions can be sub-stratified into three different subcategories including “atypia of undetermined significance/follicular lesion of undetermined significance-AUS/FLUS”; “follicular or Hürthle cell neoplasm/suspicious for follicular or Hürthle cell neoplasm-FN/SFN”; and “suspicious for malignancy-SFM”. Many of these indeterminate lesions undergo repetition or diagnostic lobectomy. Nonetheless, the majority of these cases will have a benign diagnosis due to the fact that the rate of cancer ranges between 6 and 30%. It stands to reason that the application of ancillary technique, mostly molecular testing, emerged as a critical additional tool for those thyroid indeterminate lesions. Since the early 1990s, material collected from cytological samples yields sufficient and adequate cells for the detection of point mutation or gene fusions. Nonetheless, the further availability of new sequencing technologies such as next-generation sequencing (NGS) has led to more comprehensive molecular applications adopted now in clinical use. The current review investigates the multiple advances in the field of molecular testing applied in thyroid cytology.

scholarly journals External validation of the adapted Risk of Malignancy Index incorporating tumor size in the preoperative evaluation of adnexal masses

2011 ◽  
Vol 159 (2) ◽  
pp. 422-425 ◽  
Author(s):  
Petronella A.J. van den Akker ◽  
Petra L.M. Zusterzeel ◽  
Anette L. Aalders ◽  
Marc P.L.M. Snijders ◽  
Rahul A.K. Samlal ◽  
...  
Keyword(s):  
Tumor Size ◽  
Preoperative Evaluation ◽  
External Validation ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

scholarly journals Difficulties of Differential Diagnosis of Hurthle Cell Thyroid Tumor

2021 ◽  
Vol 4 (3) ◽  
pp. 94-100
Author(s):  
T. Yu. Danzanova ◽  
E. A. Gudilina ◽  
A. A. Kalinina ◽  
P. I. Lepedatu ◽  
G. T. Sinyukova
Keyword(s):  
Research Methods ◽  
Clinical Laboratory ◽  
Correct Diagnosis ◽  
Distant Metastases ◽  
Thyroid Tumor ◽  
Malignant Neoplasms ◽  
Thyroid Cell ◽  
Hürthle Cell ◽  
Risk Of Malignancy ◽  
Patient’S History

Purpose: Assessment of the capabilities of the ultrasound method in the diagnostics of a rare Hurthle-cell tumor of the thyroid gland on the example of a clinical case of a patient with malignant neoplasms of independent primary multiple localizations in comparison with other research methods.Material and methods: A comprehensive study of materials from the history of the disease, the results of clinical, laboratory, instrumental, morphological research methods and their comparison with diagnostic cases from literature data.Results: Despite the full comprehensive examination of the patient, including ultrasound, MRI, PET/CT, puncture biopsy under ultrasound control, it was not possible to make the correct diagnosis before the operation. The presence of other malignant diseases in the patient’s history, the presence of altered paratracheal nodes in the same zone, and the rare occurrence of Hurthle thyroid tumors played a role.Conclusions: Hurthle-thyroid cell tumors are a rare disease, but it must always be taken into account in the diagnostic search, since even benign Hurthle tumors have a high risk of malignancy and spreading of distant metastases. 

Predictive factors of carcinoma in 279 patients with Hürthle cell neoplasm of the thyroid gland

2010 ◽  
Vol 101 (7) ◽  
pp. 582-586 ◽  
Author(s):  
Branka Strazisar ◽  
Rok Petric ◽  
Manja Sesek ◽  
Janez Zgajnar ◽  
Marko Hocevar ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Predictive Factors ◽  
Hürthle Cell ◽  
Cell Neoplasm

Patients’ Preferences’ Impact on Decision Making for Clinical Solitary Thyroid Nodule in a Global Healthcare Setting: A Clinical Study

2021 ◽  
Vol 3 (2) ◽  
pp. 48-58
Author(s):  
Abdalla Y Bashir ◽  
Keyword(s):  
Decision Making ◽  
Thyroid Nodule ◽  
Thyroid Surgery ◽  
Frozen Section ◽  
Management Strategies ◽  
Healthcare Setting ◽  
Objective Evaluation ◽  
Needle Aspiration ◽  
Solitary Thyroid Nodule ◽  
Risk Of Malignancy

Objective: Evaluation of patients’ preferences (PP) impact on decision-making for solitary thyroid nodule management. Study Design: A retrospective review of prospectively collected data in patients with clinical solitary nodules admitted for thyroid surgery. PP survey in various management strategies included determinants of surgery, fine-needle aspiration cytology (FNAC), frozen section (FS), and PP for total thyroidectomy (TT) or total lobectomy (TL) compared to guidelines concordance. Results: Thyroid surgery was performed for 558 patients, 75.8% were females and 43.7% were international. FNAC was done in 79.8% and refused by 20.2% due to the misperception that it spreads cancer. The risk of malignancy was the reason for choosing surgery in 35.1%. FS was preferred by 87% of the patients for decision-making (TT vs TL) in our setting with available pathology resources and low FS cost. FS based decisions were more guideline-concordant (79%) with TT performed in 41% patients compared to 74.4% in PP based decisions alone (P < 0.001). 57.9% of the patients preferred surgeon authorization for decision-making when FS was unavailable. Papillary thyroid carcinoma (PTC) occurred in 85.3%. FS diagnosed PTC in 79% of the patients with malignant nodules in inconclusive FNACs (Bethesda I, III, IV, and V). Conclusion: Decisions (TT vs TL) based on PP and beliefs compared to FS based decisions were less guideline-concordant (21% vs 79%) with more TT performed (74.4% vs 41%) (P < 0.001). Advancing patients’ knowledge on their disease, guidelines, and equipoise awareness is needed for better-shared decision-making.

Sign in / Sign up

Export Citation Format

Share Document