Should subcentimeter non-invasive encapsulated, follicular variant of papillary thyroid carcinoma be included in the noninvasive follicular thyroid neoplasm with papillary-like nuclear features category?

Xu, Bin; Farhat, Nada; Barletta, Justine A.; Hung, Yin P.; Biase, Dario de; Casadei, Gian Piero; Önenerk, Ayşe Mine; Tuttle, R. Michael; Roman, Benjamin R.; Katabi, Nora; Nosé, Vânia; Sadow, Peter M.; Tallini, Giovanni; Faquin, William C.; Ghossein, Ronald

doi:10.1007/s12020-017-1484-1

Cited by 60 publications

(34 citation statements)

References 31 publications

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“…These and many other studies, including those with a smaller number of cases, confirm that the application of strict criteria for the diagnosis of NIFTP means that metastasis and BRAF mutations are not observed (13,91,92). Moreover, the available data indicate that both large NIFTPs (with a diameter ≥4 cm) and tumours with a diameter ≤1 cm that meet the NIFTP criteria (not included in the original study because of limited or lack of supportive data) do not differ from their 'average size' counterparts and show exceptionally indolent behaviour (93,94,95,96).…”

Section: Doubts Concerning the Indolent Behaviour Of Niftpmentioning

confidence: 71%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Zajkowska

Kopczyński

Góźdż

et al. 2020

Endocrine Connections

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a borderline thyroid tumour formerly known as noninvasive encapsulated follicular variant of papillary thyroid carcinoma. The prevalence of NIFTP is estimated at 4.4–9.1% of all papillary thyroid carcinomas worldwide; however, the rate of occurrence of NIFTP is eight times lower in Asian countries than in Western Europe and America. At the molecular level, NIFTP is characterised by the lack of BRAF V600E and BRAF V600E-like mutations or other high-risk mutations (TERT, TP53) and a high rate of RAS mutations, which is similar to other follicular-pattern thyroid tumours. The diagnosis of NIFTP can only be made after histological examination of the entire tumour removed during surgery and is based on strictly defined inclusion and exclusion criteria. Although the diagnosis is postoperative, the combination of certain findings of preoperative tests including ultrasonography, cytology, and molecular testing may raise suspicion of NIFTP. These tumours can be effectively treated by lobectomy, although total thyroidectomy remains an option for some patients. Radioactive iodine and thyroid stimulating hormone suppression therapy are not required. NIFTP has an extremely good prognosis, even when treated conservatively with lobectomy alone. Nevertheless, it cannot be considered as a benign lesion. The risk of adverse outcomes, including lymph node and distant metastases, is low but not negligible.

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Section: Doubts Concerning the Indolent Behaviour Of Niftpmentioning

confidence: 71%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Zajkowska

Kopczyński

Góźdż

et al. 2020

Endocrine Connections

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“…The size of the tumor does not constitute a criterion for the diagnosis of NIFTP (Nikiforov et al 2018), although some cases require greater care and time-consuming evaluation to ensure the absence of excluding findings. Reviewing 250 patients with subcentimeter NIFTP from nine studies (Thompson 2016, Can et al 2017, Hahn et al 2017, Kwon et al 2017, Johnson & Sadow 2018, Mainthia et al 2018, Rosario 2018c, Shafique et al 2018, Xu et al 2018, without associated PTC, we found only two patients with micrometastases <2 mm in a single lymph node in the central compartment, none with distant metastases and no case of recurrence. In addition, reviewing 265 patients with NIFTP ≥4 cm (Thompson 2016, Golding et al 2017, Kwon et al 2017, Rosario 2017b, Xu et al 2017a, Chereau et al 2019, Kim et al 2018b, Mainthia et al 2018, Parente et al 2018, excluding cases with associated PTC, we did not identify any patients with lymph node metastases (LNM), only one with pulmonary metastases and no case of recurrence.…”

Section: Diagnosis Of Niftpmentioning

confidence: 89%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Rosário

Mourão

2019

Endocrine-Related Cancer

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an encapsulated or clearly delimited, noninvasive neoplasm with a follicular growth pattern and nuclear features of papillary thyroid carcinoma (PTC). It is considered a ‘pre-malignant’ lesion of the RAS-like group. Ultrasonography (US), cytology and molecular tests are useful to suspect thyroid nodules that correspond to NIFTP but there is wide overlap of the results with the encapsulated follicular variant of PTC (E-FVPTC). In these nodules that possibly or likely correspond to NIFTP, if surgery is indicated, lobectomy is favored over total thyroidectomy. The diagnosis of NIFTP is made after complete resection of the lesion by observing well-defined criteria. In the case of patients who received the diagnosis of FVPTC and whose pathology report does not show findings of malignancy (lymph node metastasis, extrathyroidal invasion, vascular/capsular invasion), if the tumor was encapsulated or well delimited, the slides can be revised by an experienced pathologist to determine whether the diagnostic criteria of NIFTP are met, but special attention must be paid to the adequate representativeness of the capsule and tumor. Since NIFTP is not ‘malignant’, tumor staging is not necessary and patients are not submitted to thyroid cancer protocols or guidelines. We believe that patients with NIFTP without associated malignancy and without nodules detected by US of the remnant lobe (if submitted to lobectomy) can be managed like those with follicular adenoma.

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“…Cases without initial agreement were shown at a multihead microscope to generate a consensus diagnosis. Subcentimeter nodules showing morphologic features consistent with NIFTP were still classified as such despite the size criterion …”

Section: Methodsmentioning

confidence: 99%

“…Subcentimeter nodules showing morphologic features consistent with NIFTP were still classified as such despite the size criterion. 31,32…”

Section: Reclassification Of Niftpmentioning

confidence: 99%

The impact of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features on the rate of malignancy for atypia of undetermined significance subcategories

Hang

Westra

Zhou

et al. 2018

Cancer Cytopathology

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Should subcentimeter non-invasive encapsulated, follicular variant of papillary thyroid carcinoma be included in the noninvasive follicular thyroid neoplasm with papillary-like nuclear features category?

Cited by 60 publications

References 31 publications

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

The impact of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features on the rate of malignancy for atypia of undetermined significance subcategories

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