Muhammed Kizilgul1,2, Rupendra Shrestha1, Angela Radulescu1, Maria R Evasovich1, Lynn A Burmeister3. 1. Department of Medicine, Surgery University of Minnesota, Minneapolis, MN, USA. 2. Department of Endocrinology and Metabolism, UHS Diskapi Training and Research Hospital, Ankara, Turkey. 3. Department of Medicine, Surgery University of Minnesota, Minneapolis, MN, USA. Burme008@umn.edu.
Abstract
PURPOSE: Whether thyroid nodules 4 cm or larger with benign cytology carry a higher risk of malignancy, and should be managed differently than smaller nodules remains controversial. We aimed to evaluate the malignancy rate and benign cytology false-negative rate in thyroid nodules ≥4 cm compared with those <4 cm. METHODS: All thyroidectomies between January 2010 and December 2014 were reviewed. Patient demographics, preoperative sonographic nodule size, fine needle aspiration cytology (FNAC), and final surgical pathology results were compared for index nodules ≥4 vs. <4 cm. RESULTS: A total of 490 index nodules with preoperative FNAC were identified. A total of 137 nodules were ≥4 cm and 353 nodules were <4 cm. The prevalence of carcinoma was lower (23 vs. 53%) in nodules ≥4 vs. <4 cm (p < 0.0001). The false-negative rate of benign FNAC for ≥4 and <4 cm index nodule was 5.2% and 5.9%, respectively (p = 1.000). CONCLUSIONS: This study shows that thyroid nodules ≥4 cm do not have a higher malignancy rate at surgery nor higher benign cytology false-negative rate than smaller nodules. Thyroid nodules over 4 cm do not require resection, to rule out malignancy, based on size alone.
PURPOSE: Whether thyroid nodules 4 cm or larger with benign cytology carry a higher risk of malignancy, and should be managed differently than smaller nodules remains controversial. We aimed to evaluate the malignancy rate and benign cytology false-negative rate in thyroid nodules ≥4 cm compared with those <4 cm. METHODS: All thyroidectomies between January 2010 and December 2014 were reviewed. Patient demographics, preoperative sonographic nodule size, fine needle aspiration cytology (FNAC), and final surgical pathology results were compared for index nodules ≥4 vs. <4 cm. RESULTS: A total of 490 index nodules with preoperative FNAC were identified. A total of 137 nodules were ≥4 cm and 353 nodules were <4 cm. The prevalence of carcinoma was lower (23 vs. 53%) in nodules ≥4 vs. <4 cm (p < 0.0001). The false-negative rate of benign FNAC for ≥4 and <4 cm index nodule was 5.2% and 5.9%, respectively (p = 1.000). CONCLUSIONS: This study shows that thyroid nodules ≥4 cm do not have a higher malignancy rate at surgery nor higher benign cytology false-negative rate than smaller nodules. Thyroid nodules over 4 cm do not require resection, to rule out malignancy, based on size alone.
Entities:
Keywords:
False-negative rate; Size; Thyroid carcinoma; Thyroid nodule; ≥4 cm
Authors: Sophia C Kamran; Ellen Marqusee; Mathew I Kim; Mary C Frates; Julie Ritner; Hope Peters; Carol B Benson; Peter M Doubilet; Edmund S Cibas; Justine Barletta; Nancy Cho; Atul Gawande; Daniel Ruan; Francis D Moore; Karla Pou; P Reed Larsen; Erik K Alexander Journal: J Clin Endocrinol Metab Date: 2012-12-28 Impact factor: 5.958
Authors: Sarah Khalife; Sarah Bouhabel; Veronique-Isabelle Forest; Michael P Hier; Louise Rochon; Michael Tamilia; Richard J Payne Journal: J Otolaryngol Head Neck Surg Date: 2016-05-04
Authors: Samantha N Steinmetz-Wood; Amanda G Kennedy; Bradley J Tompkins; Matthew P Gilbert Journal: Int J Endocrinol Date: 2022-04-16 Impact factor: 2.803
Authors: Agnes Stephanie Harahap; Desty Gusti Sari; Marini Stephanie; Alvita Dewi Siswoyo; Litta Septina Mahmelia Zaid; Diani Kartini; Maria Francisca Ham; Tri Juli Edi Tarigan Journal: J Thyroid Res Date: 2022-01-11
Authors: Whitney Sutton; Joseph K Canner; Lisa M Rooper; Jason D Prescott; Martha A Zeiger; Aarti Mathur Journal: Am J Surg Date: 2020-06-02 Impact factor: 2.565