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. 2021 Aug 1;22(8):2597-2602.
doi: 10.31557/APJCP.2021.22.8.2597.

Thyroid Nodule Size as a Predictor of Malignancy in Follicular and Hurthle Neoplasms

Arunnit Boonrod  1   2 , Zeynettin Akkus  2 , M Regina Castro  3 , Atefeh Zeinodini  2 , Kenneth Philbrick  2 , Marius Stan  3 , Dana Erickson  3 , Bradley Erickson  2
Affiliations

Thyroid Nodule Size as a Predictor of Malignancy in Follicular and Hurthle Neoplasms

Arunnit Boonrod et al. Asian Pac J Cancer Prev. .

Abstract

Introduction: The management of follicular (FN) and Hurthle cell neoplasms (HCN) is often difficult because of the uncertainty of malignancy risk. We aimed to assess characteristics of benign and malignant follicular and Hurthle neoplasms based on their shape and size.

Materials and methods: Patients with Follicular adenoma (FA) or carcinoma (FC) and Hurthle Cell adenoma (HCA) or carcinoma (HCC) who had preoperative ultrasonography were included. Demographic data were retrieved. Size and shape of the nodules were measured. Logistic regression analyses and odds ratios were performed.

Results: A total of 115 nodules with 57 carcinomas and 58 adenomas were included. Logistic regression analysis shows that the nodule height and the patient age are predictors of malignancy (p-values = 0.001 and 0.042). A cutoff value of nodule height ≥ 4 cm. produces an odds ratio of 4.5 (p-value = 0.006). An age ≥ 55 year-old demonstrates an odds ratio of 2.4-3.6 (p-value = 0.03). Taller-than-wide shape was not statistically significant (p-value = 0.613).

Conclusion: FC and HCC are larger than FA and HCA in size, with a cutoff at 4 cm. Increasing age increases the odds of malignancy with a cutoff at 55 year-old. Taller-than-wide shape is not a predictor of malignancy.

Keywords: Follicular neoplasm; Hurthle cell neoplasm; Taller-than-wide; size.

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Figures

Figure 1
Figure 1
Transverse (A, B and C) and longitudinal (D) US images of an isoechoic solid thyroid nodule demonstrating the measurement method (A, B and D; depth, width and height diameters). Bounding box is drawn around the nodule (C) and the ratio between Y and X axes represents the shape of nodule. The shape of this nodule is taller-than-wide. The final pathology is a follicular adenoma
Figure 2
Figure 2
Percentage of Malignancy According to Nodule Height. **P-value = 0.006
Figure 3
Figure 3
Scatter Plot of Beam-Defined and Diameter-defined Ratios. (r = 0.768, p-value = 0.01)
See this image and copyright information in PMC

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