Rate and risks of follicular thyroid carcinoma in patients With cytologic diagnosis of follicular neoplasia.

Abstract

ABSTRACT Background: Studies have shown that the risk of malignancy in follicular neoplasms is as high as 30%. Often, surgery is recommended for such lesions, not for therapeutic purposes but as a diagnostic method, leading to increased hospital costs and related morbidities. Recent studies have suggested that tumour size predicts malignant potential of these follicular neoplasms. Objective: The aim of this study is to evaluate the rate of FTCs among the patients who have cytologic diagnosis of follicular neoplasm and to determine the clinical features of follicular thyroid carcinoma in comparison with thyroid follicular adenoma and other benign thyroid pathology. Method: A Comparative cross-sectional study design on patients who have histopathologic diagnosis of follicular adenoma and follicular carcinoma with respect to the clinical features in follicular neoplasms was reviewed from medical records retrospectively from January 2015 to December 2019, at St Paul’s Hospital Millennium Medical college, Addis Ababa, Ethiopia. subjects were identified from the hospital log books (admission, discharge and operation) and individual patient charts was reviewed for the study variables. The data was collected by trained final year medical students. After data was collected and data was analysed using SPSS software. The analyzed data presented using charts, tables, and graphs and described using texts. Result: A total of 135 patients undergoing thyroidectomy for follicular neoplasm and suspected for follicular neoplasm in the study period. Among this the record of 110 patients retrieved for analysis. Among those operated for follicular neoplasia 78 (70.9%) of them found to be benign and 32 (29.1%) of them are found to be malignant after biopsy. From those benign disease 48 (43.6%) of them are follicular adenoma and 28 (25.5%) of them are benign nodular goitre. Those diagnosed to be malignant after biopsy shares 21 (19.1%) of the case is follicular carcinoma and 11 (10%) of the patients are papillary carcinoma. Size of the mass greater than or equal to 4 cm with p value of 0.012 is strongly associated with the prevalence of follicular carcinoma than follicular adenoma. The associated symptoms of shortness breath also associated with diagnosis of follicular carcinoma. Conclusion: Lesions larger than or equal to 4 cm in diameter and lesion associated with other added symptoms like shortness of breath, and difficulty of swallowing diagnosed as suspicious for follicular neoplasm by FNA cytology are associated with an increased risk of the presence of a malignant tumour.