[Malignant or benign thyroid nodules: a diagnostic dilemma].

Area of Science:

• Endocrinology
• Oncology
• Diagnostic Imaging

Background:

• Thyroid nodules are common, but distinguishing benign from malignant lesions requires accurate diagnostic methods.
• Cystic and cystoid-solid changes within thyroid nodules can complicate diagnosis.
• Preoperative assessment is crucial for effective thyroid cancer management.

Purpose of the Study:

• To determine the incidence of cystic and cystoid-solid lesions in thyroid carcinomas.
• To evaluate the diagnostic utility of ultrasonography (USG) and fine needle aspiration biopsy (FNAB) in these cases.
• To correlate preoperative findings with postoperative histopathological results.

Main Methods:

• Retrospective analysis of 661 surgically treated patients with thyroid disorders.
• Preoperative ultrasonographic examinations (USG) for lesion characterization.
• Fine needle aspiration biopsy (FNAB) for cytological evaluation.
• Postoperative histopathological examination for definitive diagnosis.

Main Results:

• Thyroid carcinoma was diagnosed in 46 patients (3.9%), with papillary carcinoma being most common (n=34).
• Preoperative USG identified cystic or cystoid-solid lesions in 39% (18/46) of carcinoma patients.
• FNAB yielded positive, negative, or suspect results in these 18 patients; malignancy was confirmed histopathologically.
• Malignant neoplasms were associated with cystic/cystoid-solid lesions in approximately 40% of cases.

Conclusions:

• Malignant thyroid neoplasms frequently exhibit cystic and cystoid-solid features.
• Multiple USG-guided FNABs may be necessary for adequate sampling.
• A negative FNAB result does not exclude thyroid carcinoma, particularly in nodular-cystic goiters.