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Tumour growth rate of follicular thyroid carcinoma is not different from that of follicular adenoma
Author(s) -
Kim Mijin,
Han Minkyu,
Lee Jeong Hyun,
Song Dong Eun,
Kim Kyunggon,
Baek Jung Hwan,
Shong Young Kee,
Kim Won Gu
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13591
Subject(s) - medicine , follicular phase , nodule (geology) , thyroid , adenoma , malignancy , thyroid carcinoma , follicular carcinoma , carcinoma , gastroenterology , cytology , thyroid nodules , pathology , urology , papillary carcinoma , biology , paleontology
Summary Objective Distinguishing malignancy from benign thyroid nodule has always been challenging, especially in follicular lesions. Thyroid nodules with small size and indeterminate cytology do not lead to immediate surgery. We tried to evaluate whether tumour size and tumour growth rate can distinguish follicular thyroid carcinoma ( FTC ) from follicular adenoma ( FA ). Design and Patients This retrospective study included patients with pathologically proven FTC s (n = 50) and FA s (n = 110) who underwent preoperative serial neck ultrasonography ( US ) at least 3 times: it comprises 30% of all follicular tumours (32% FA s and 25% FTC s). The growth rates of follicular tumours on serial US were measured using at least 3 consecutive examinations during a median follow‐up of 4.1 years (range, 0.7‐13.3 years) by experienced radiologists. Results The FA and FTC groups showed no significant difference in clinicopathological characteristics, including age, proportion of large nodules (>4 cm) and preoperative cytology. The maximum diameter of thyroid nodule was gradually increased in both groups with statistical significance ( P < .001 and P < .001, respectively). No significant differences in change of maximum diameter of thyroid nodule ( P = .132) and tumour volume ( P = .208) were found between the FA and FTC groups during the follow‐up. The median time to a significant tumour growth from baseline was not different between the FA and FTC groups (1.4 years and 1.7 years, respectively, P = .556). When we divided the patients into four groups (rapid, moderate, slow and no growth) according to the growth velocity of the thyroid tumours, no significant difference in growth velocity was found among the groups. Conclusions The tumour size and growth rate of the thyroid nodule itself could not predict malignancy. Diagnostic approaches that use molecular markers would be more important than clinical features for the decision of diagnostic surgery for patients with follicular tumours.