Predictive Factors Increasing the Risk of Malignancy in Thyroid Follicular Neoplasia

Introduction: 22-42% of patients with thyroid nodules are diagnosed as Bethesda category IV “Follicular Neoplasia (FN)”. The aim of this study is to evaluate our clinical results in patients with FN who underwent surgery and determine predictive risk factors in patients with malignant pathology results. Materials and Methods: 364 patients were included in the study. Fine needle aspirastion biopsy (FNAB) with a FN result was defined as a “target nodule”. Demographic, radiological and clinical characteristics of the two groups were determined. Two different types of surgical procedures were applied to the patients: HT or TT. Results: The number of patients was 199 (54.7%) in Group 1 and 165 (45.3%) in Group 2. Malignancy was incidentally detected in 138 patients (37.9%) outside the target nodule. The risk of malignancy was higher in those under 45 compared to those aged 45 and older. Malignancy was observed in 123 (42.7%) of female patients and 42 (55.3%) of male patients. Additionally, the risk of malignancy increased in patients with nodules measuring 2 cm or larger. Conclusion: In FN cases, the risk of malignancy increases in males, in nodules 2 cm and above, and in younger age groups. According to our data, the risk of malignancy in FN is 45.3%. Additionally, the rate of incidental thyroid cancer is 37.9%. We attribute the higher rates of these findings compared to literature to the increased frequency of thyroid cancer in our region.