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Cystic change in thyroid cancer.

Jen-Der Lin1, Chuen Hsuen, Jeng-Yeou Chen

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Cystic changes in thyroid nodules are common, with a high positive predictive value for papillary carcinoma. However, accurately diagnosing these cystic thyroid cancers before surgery remains challenging.

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiology

Background:

  • Ultrasonography is crucial for detecting thyroid nodules.
  • Cystic changes are frequently observed in thyroid nodules.

Purpose of the Study:

  • Determine the incidence of cystic changes in thyroid cancer detected by ultrasonography.
  • Compare the diagnostic accuracy of fine-needle aspiration cytology (FNAC) in solid versus cystic thyroid nodules.

Main Methods:

  • Retrospective analysis of 6219 patients with thyroid nodules.
  • Categorization of nodules into solid (4236) and cystic (1983) based on ultrasonography.
  • Evaluation of FNAC results and surgical outcomes.

Main Results:

  • Malignancy rates were 29.8% in surgically treated solid nodules and 9.1% in cystic nodules.
  • Thyroid cancer was diagnosed in 0.65% of surgically treated cystic thyroid lesions.
  • FNAC diagnostic accuracy for cystic thyroid masses was comparable to solid nodules.

Conclusions:

  • Cystic changes in thyroid masses are prevalent.
  • A high positive predictive value exists for diagnosing papillary carcinoma in cystic thyroid masses.
  • Preoperative diagnosis of cystic thyroid cancer presents difficulties.