Investigation of pre-operative demographic, biochemical, sonographic and cytopathological findings in low-risk thyroid neoplasms

Clin Endocrinol (Oxf). 2023 Nov;99(5):502-510. doi: 10.1111/cen.14965. Epub 2023 Sep 14.


Objective: The present article analyses pre-operative demographic, biochemical, sonographic and histopathological characteristics of low-risk thyroid neoplasms (LRTNs), with a focus on four subgroups, "well-differentiated carcinoma-not otherwise specified" (WDC-NOS), "non-invasive follicular thyroid neoplasm with papillary like nuclear features" (NIFTP), "well-differentiated tumours of uncertain malignant potential" (WDT-UMP) and "follicular tumour of uncertain malignant potential" (FT-UMP).

Methods: The study retrospectively analyzed the histopathology of 2453 malignant thyroids and the final analyses included 99 cases diagnosed with LRTNs. The demographic and clinical features, pre-operative thyroid function, ultrasonography results, cytopathology results, histopathology results and prognostic classifications were assessed.

Results: The groups were similar demographic characteristics and the majority of clinical data, including comorbidities, thyroid function tests, thyroid cancer/neck radiotherapy history. NIFTPs represented 69.7% of all LRTNs. All (100%) WDT-UMPs had solitary nodules. Index nodule volume differed among the groups (p = .036), it was the lowest in WDC-NOS [0.68 (0.63-0.72 cc)] and highest in FT-UMP [12.6 (0.5-64 cc)]. Echogenicity findings were similar. Index nodule TIRADS demonstrated a significant difference (p = .021) but index nodule halo sign and BETHESDA scores were similar in all groups. The diameter, localisation and multicentric structure of LRTNs were again similar for all groups. Finally, prognostic scores suggested similar outcomes in all groups.

Conclusion: The majority of LRTNs were NIFTPs in our population and all WDT-UMPs were solitary lesions. Index nodule volume was the most essential discriminating sonographic finding but further research must be performed before discriminatory potential can be described.

Keywords: follicular tumour of uncertain malignant potential; low-risk thyroid neoplasms; non-invasive follicular thyroid neoplasm with papillary-like nuclear features; well-differentiated carcinoma-not otherwise specified; well-differentiated tumours of uncertain malignant potential.

MeSH terms

  • Adenocarcinoma, Follicular* / diagnostic imaging
  • Adenocarcinoma, Follicular* / pathology
  • Demography
  • Humans
  • Retrospective Studies
  • Thyroid Neoplasms* / pathology
  • Ultrasonography