Malignancy risk in indeterminate thyroid nodules with Hürthle cells: role of autoimmune thyroiditis

Perticone, F.; Maggiore, Riccardo; Mari, Gilberto; Frara, Stefano; Baldassarre, Paola; Doglioni, Claudio; Lena, Marco Schiavo; Rosati, Riccardo; Lanzi, Roberto; Giustina, Andrea

doi:10.1007/s12020-021-02932-6

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…The 2015 American Thyroid Association guidelines address OTC as a variant of FTC and apply the same risk stratification parameters, with diagnostic lobectomy an accepted intervention for a nodule less than 4 cm, unless clinical features prompt consideration of more extensive resection . Ultimately, less than 10% of nodules that undergo surgery for an FNAB interpreted as suggestive for Hürthle cell (oncocytic) neoplasm (Bethesda System, category IV), prove to be OTC . More extensive surgical intervention may result from preoperative recognition of lymph node metastasis or evidence of distant disease.…”

Section: Observationsmentioning

confidence: 99%

Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma

Bischoff,

Ganly,

Fugazzola

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceOncocytic (Hürthle cell) thyroid carcinoma is a follicular cell-derived neoplasm that accounts for approximately 5% of all thyroid cancers. Until recently, it was categorized as a follicular thyroid carcinoma, and its management was standardized with that of other differentiated thyroid carcinomas. In 2022, given an improved understanding of the unique molecular profile and clinical behavior of oncocytic thyroid carcinoma, the World Health Organization reclassified oncocytic thyroid carcinoma as distinct from follicular thyroid carcinoma. The International Thyroid Oncology Group and the American Head and Neck Society then collaborated to review the existing evidence on oncocytic thyroid carcinoma, from diagnosis through clinical management and follow-up surveillance.ObservationsGiven that oncocytic thyroid carcinoma was previously classified as a subtype of follicular thyroid carcinoma, it was clinically studied in that context. However, due to its low prevalence and previous classification schema, there are few studies that have specifically evaluated oncocytic thyroid carcinoma. Recent data indicate that oncocytic thyroid carcinoma is a distinct class of malignant thyroid tumor with a group of distinct genetic alterations and clinicopathologic features. Oncocytic thyroid carcinoma displays higher rates of somatic gene variants and genomic chromosomal loss of heterozygosity than do other thyroid cancers, and it harbors unique mitochondrial DNA variations. Clinically, oncocytic thyroid carcinoma is more likely to have locoregional (lymph node) metastases than is follicular thyroid carcinoma—with which it was formerly classified—and it develops distant metastases more frequently than papillary thyroid carcinoma. In addition, oncocytic thyroid carcinoma rarely absorbs radioiodine.Conclusions and RelevanceThe findings of this review suggest that the distinct clinical presentation of oncocytic thyroid carcinoma, including its metastatic behavior and its reduced avidity to radioiodine therapy, warrants a tailored disease management approach. The reclassification of oncocytic thyroid carcinoma by the World Health Organization is an important milestone toward developing a specific and comprehensive clinical management for oncocytic thyroid carcinoma that considers its distinct characteristics.

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Section: Observationsmentioning

confidence: 99%

Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma

Bischoff,

Ganly,

Fugazzola

et al. 2024

JAMA Otolaryngol Head Neck Surg

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Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm

Sparano,

Puccioni,

Adornato

et al. 2023

J Endocrinol Invest

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Purpose Indeterminate cytology still puzzles clinicians, due to its wide range of oncological risks. According to the Italian SIAPEC–IAP classification, TIR3B cytology holds up to 30% of thyroid cancer, which justifies the surgical indication, even if more than half of cases do not result in a positive histology. The study aim is to identify potential clinical, ultrasound or cytological features able to improve the surgical indication. Methods Retrospective analysis. A consecutive series of TIR3B nodules referred to the Endocrine Unit of Careggi Hospital from 1st May 2014 to 31st December 2021 was considered for the exploratory analysis (Phase 1). Thereafter, a smaller confirmatory sample of consecutive TIR3B diagnosed and referred to surgery from 1st January 2022 to 31st June 2022 was considered to verify the algorithm (Phase 2). The main clinical, ultrasound and cytological features have been collected. A comprehensive stepwise logistic regression was applied to build a prediction algorithm. The histological results represented the final outcome. Results Of 599 TIR3B nodules referred to surgery, 451 cases were included in the exploratory analysis. A final score > 14.5 corresponded to an OR = 4.98 (95% CI 3.24–7.65, p < 0.0001) and showed a PPV and NPV of 57% and 79%, respectively. The Phase 2 analysis on a confirmatory sample of 58 TIR3B cytology confirmed that a threshold of 14.5 points has a comparable PPV and NPV of 53% and 80%, respectively. Conclusions A predictive algorithm which considers the main clinical, US and cytological features can significantly improve the oncological stratification of TIR3B cytology.

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Clinicopathological study of nodular goiter and thyroid malignancy in Tertiary Care Hospital

Raj

Ray

Vengadesh

et al. 2022

ijhs

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Nodular goiter is a clinicopathological entity characterized by an increased volume of the thyroid gland with formation of nodules. Nodular goiter occurs due to repeated hyperstimulation of thyroid gland due to iodine deficiency, goitrogens, anti-thyroid drugs and genetic defects. Nodular goiter can have different complications which include tracheal compression, retrosternal extension, malignancy and secondary thyrotoxicosis. The present study attempted to study clinical presentation of nodular goiter and to determine the incidence of thyroid cancer in solitary nodular goiter and multinodular goiter in patients admitted in surgery ward of IGMCRI, Puducherry. Retrospective record-based study and single-center study was carried out between January-2011 to December-2019 on consecutive 230 patients admitted in surgery ward with nodular goiter and age above 18 years. Ethics approval was obtained from Institute Ethics Committee (IEC) of IGMCRI. Demographic variables (age and gender), Diagnosis, FNAC, BIOPSY and Carcinoma frequency was assessed in the present study. Data was entered in Microsoft Excel spreadsheet and the data underwent analysis using descriptive statistics involving tables, graphs and bar diagrams. In our study, majority of the study participants (90.4%) belonged to female gender. Maximum patient cases (34.78%) belonged to adult range within 31-40 years.

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Malignancy risk in indeterminate thyroid nodules with Hürthle cells: role of autoimmune thyroiditis

Cited by 3 publications

References 20 publications

Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma

Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma

Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm

Clinicopathological study of nodular goiter and thyroid malignancy in Tertiary Care Hospital

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