Filters

2025 - 20262
Reset filters

Settings

Subject: Thyroid Cancer

Search Results

Now showing 1 - 2 of 2
  • Thumbnail Image
    Article
    Malignancy in Toxic Thyroid Adenoma: Revisiting Risk Assessment and Identifying Predictors
    (Springer, 2026) Calapkulu, Murat; Cayir, Derya; Sencar, Muhammed Erkam; Cakal, Erman; Sakiz, Davut; Unsal, Ilknur Ozturk; Tekinyildiz, Merve
    Background Toxic adenomas have traditionally been considered benign due to chronic TSH suppression, which is believed to inhibit thyroid tumorigenesis. However, emerging data challenge this dogma, reporting non-negligible malignancy rates even in toxic adenoma. This study aimed to assess thyroid cancer frequency and characteristics in surgically selected patients with toxic adenomas and to compare outcomes with propensity score-matched, surgically treated non-functioning nodules. Methods This retrospective, cross-sectional study included 204 surgically treated patients at a tertiary referral center, comprising 102 surgically selected toxic adenomas and 102 propensity score-matched, surgically treated non-functioning nodules. Clinical, biochemical, sonographic, scintigraphic, and histopathological data were analyzed. Multivariate logistic regression analysis was used to identify independent predictors of malignancy among toxic adenomas. Results In this surgically selected cohort, the malignancy rate was 16.7% for toxic adenomas and 40.2% for non-functioning nodules (p < 0.001). Papillary thyroid carcinoma comprised 82.4% of all cases, making it the leading histotype (82.4%). Among toxic nodules, higher fT4/fT3 ratio (cut-off:2.58, sensitivity:93.3%, specificity:54.2%) and European Thyroid Imaging and Reporting Data System categories 4-5 were independent predictors of malignancy. No significant differences were found between groups in terms of tumor size, invasion, American Thyroid Association risk stratification, or 5-year response rates. Conclusion Among surgically treated patients, the observed malignancy rate in toxic adenomas appears to be higher than traditionally expected. Elevated fT4/fT3 ratio and suspicious ultrasound features warrant closer evaluation. These findings support using ultrasound and biochemical markers in risk assessment of all thyroid nodules, regardless of functional status.
  • Thumbnail Image
    Article
    Citation - WoS: 1
    Citation - Scopus: 1
    Ongoing Discussion: Is Prophylactic Central Neck Dissection Necessary in Ct1a-B,2n0 Papillary Thyroid Cancer
    (Sage Publications Ltd, 2025) Bayir, Omer; Akan, Latif; Kizilgul, Muhammed; Ucan, Bekir; Karahan, Sevilay; Toptas, Gokhan; Korkmaz, Mehmet Hakan
    Objective: To analyze the central lymph node metastasis (CLNM) rates of patients who underwent prophylactic central lymph node dissection (pCLND) with total thyroidectomy for cT1-2N0 papillary thyroid cancer in our clinic, to evaluate the conditions associated with lymph node metastasis, and to examine the necessity of pCLND in these patient groups.Methods: This study includes a retrospective review of the medical data of patients who underwent bilateral/unilateral central lymph node dissection (CLND) (b/uCLND) with total thyroidectomy in our center between 2013 and 2021, whose fine needle aspiration biopsy result was reported as malignant, who were detected as cT1a-1b-2N0 on thyroid and neck ultrasonography.Results: Of the 251 patients included in the study, 63 (25%) had CLNM (49 (19.5%) ipsilateral and 14 (5.5%) had contralateral CLNM). Twenty-two (20.1%) of 109 patients with cT1a, 30 (28.3%) of 106 patients with cT1b, and 11 (30.5%) of 36 patients with cT2 had CLNM, and metastasis rates increased with increasing cT category. CLNM rates increased with increasing pT category (p=0.005). CLNM was present in 21 (38.8%) of 54 patients (21.5%) with collision tumors, and metastasis rates increased significantly compared to the presence of a single histopathologic tumor (p=0.006). CLNM rates were higher in patients with multicentric tumor localization than in those with unicentric localization (p=0.006).Conclusion: Multicentricity, bilaterality, capsule invasion, collision tumors and tumors larger than 1 cm increase the risk of CLNM. uCLND for tumors larger than 1 cm, bCLND for tumors larger than 2 cm can be considered. We believe that patients with unilateral CLNM also have an increased risk of contralateral metastasis.