Abstrato

Risk of thyroid carcinoma in patients treated surgically with assumed benign cytology ®in Riyadh, Saudi Arabia

Abdelaziz AL Salem

Objectives: This study aimed to report thyroid malignancy rate in benign fine-needle aspiration (Bethesda II) at King Abdelaziz Medical City and to evaluate the factors that affect the false-negative outcomes of FNA.

Methods: All patients referred for thyroidectomy from 2009 to 2019 were reviewed (n = 1968). Only patients with a benign FNA, corresponding to the Bethesda II, were included (n = 384). Information on age, gender, body mass index (BMI), serum thyroidstimulating hormone, type of surgery and histopathological outcomes were retrieved.

Results: Of the sample (n=384) with an initial benign FNA, 63 patients had a malignancy on the postoperative pathological examination, yielding an overall false-negative rate of 16.4%. The most frequently reported histopathological type was papillary thyroid microcarcinomas (n=52). For the false-negative group, the mean age was 43.8 years (range 21-70 years) with an 84.1% female predominance. The surgical choice for 74% (n=46) of the cases was total thyroidectomy. Age, gender, thyroid function and BMI did not affect the false-negative rate of benign FNA (p>0.05).

Conclusion: This study indicated a higher risk of malignancy compared to literature related to benign FNA. The risk of malignancy should be considered, even with benign FNA