Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in children and adolescents

Rosário, Pedro Weslley; Mourão, Grabriela Franco

doi:10.1007/s12020-018-1667-4

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…Despite the small number of reported cases, the diagnosis of NIFTP also applies to children and adolescents and the absence of metastases has been demonstrated in this age group (Chereau et al 2019, Rosario & Mourão 2018.…”

Section: Diagnosis Of Niftpmentioning

confidence: 94%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Rosário

Mourão

2019

Endocrine-Related Cancer

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an encapsulated or clearly delimited, noninvasive neoplasm with a follicular growth pattern and nuclear features of papillary thyroid carcinoma (PTC). It is considered a ‘pre-malignant’ lesion of the RAS-like group. Ultrasonography (US), cytology and molecular tests are useful to suspect thyroid nodules that correspond to NIFTP but there is wide overlap of the results with the encapsulated follicular variant of PTC (E-FVPTC). In these nodules that possibly or likely correspond to NIFTP, if surgery is indicated, lobectomy is favored over total thyroidectomy. The diagnosis of NIFTP is made after complete resection of the lesion by observing well-defined criteria. In the case of patients who received the diagnosis of FVPTC and whose pathology report does not show findings of malignancy (lymph node metastasis, extrathyroidal invasion, vascular/capsular invasion), if the tumor was encapsulated or well delimited, the slides can be revised by an experienced pathologist to determine whether the diagnostic criteria of NIFTP are met, but special attention must be paid to the adequate representativeness of the capsule and tumor. Since NIFTP is not ‘malignant’, tumor staging is not necessary and patients are not submitted to thyroid cancer protocols or guidelines. We believe that patients with NIFTP without associated malignancy and without nodules detected by US of the remnant lobe (if submitted to lobectomy) can be managed like those with follicular adenoma.

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Section: Diagnosis Of Niftpmentioning

confidence: 94%

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Rosário

Mourão

2019

Endocrine-Related Cancer

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“…12,13,16,17 However, studies describing the tumor characteristics and behavior of NIFTP in the pediatric population are scant, with only a total of 12 cases reported in the literature. 18–21 It is not clear if the experience of NIFTP derived from studies predominantly in adult patients can be equally applied to children, given the clinicopathologic differences between PTC in adult and pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features in Children: An Institutional Experience and Literature Review

et al. 2019

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Background Papillary thyroid carcinoma (PTC) in children has a distinctive set of clinicopathologic features and molecular signature compared to their adult counterparts. The recent recommendation to reclassify encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) without invasion as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is based on evidence derived almost exclusively from studies in adults. Clinicopathologic studies restricted to pediatric NIFTP are limited. Methods We retrospectively analyzed all pediatric PTC and NIFTP diagnosed and treated in our institution from 1999 to 2016 (n = 31). Results Using recently published consensus diagnostic criteria, we identified 3 NIFTP and 2 infiltrative follicular variants of papillary thyroid carcinoma (FVPTC) among 31 cases. Two of the NIFTP cases were initially diagnosed as EFVPTC. All 3 patients with NIFTP had unifocal tumors of lower American Joint Committee on Cancer (AJCC) classification (T2 or lower) and were free of lymph node or distant metastasis. Total (n = 1) or completion (n = 2) thyroidectomy was performed in all cases, and only 1 NIFTP patient received subsequent radioablative therapy. No residual or recurrent disease has been observed during follow-up (15–138 months) in patients with NIFTP. Conclusions Our experience with NIFTP in children is similar to outcomes reported in adult studies, suggesting that pediatric NIFTP behave indolently as evidenced by the absence of local recurrence in our cohort.

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“…Since pediatric PTCs usually have clinicopathological and molecular features that differ from those of adults and tend to be more aggressive (with higher recurrence rates), many authors raise doubts and concern as to whether NIFTP in children should be treated in the same way as adults. However, the few reported NIFTP cases in the pediatric population showed an indolent behavior, with no lymph node or distant metastases or local recurrences (Rossi et al 2018;Rosario and Mourão 2018;Wang et al 2020). The current data therefore suggest that even pediatric NIFTP can be managed in a more conservative way, with lobectomy and no lymph node dissection or subsequent radioablation therapy.…”

Section: Can Niftp Occur In Children?mentioning

confidence: 61%

“…In the pediatric population, NIFTP seems to be less frequent, probably due to the higher prevalence of classical PTC and other aggressive variants. As for the adult population, pediatric NIFTPs usually show a low-intermediate risk at the ultrasound evaluation and at FNA are classified within the indeterminate categories (Bethesda III, IV and V) (Rosario and Mourão 2018). Since pediatric PTCs usually have clinicopathological and molecular features that differ from those of adults and tend to be more aggressive (with higher recurrence rates), many authors raise doubts and concern as to whether NIFTP in children should be treated in the same way as adults.…”

Section: Can Niftp Occur In Children?mentioning

confidence: 99%

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: From Echography to Genetic Profile

Maletta

Falco

Gambella

et al. 2020

Tohoku J. Exp. Med.

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In thyroid pathology, the great variety of types and the wide range of aggressiveness of thyroid cancers complicate both diagnosis and management. In 2016, a subset of noninvasive encapsulated follicular variant of papillary thyroid carcinoma was reclassified as noninvasive follicular thyroid tumor with papillarylike nuclear features (NIFTP) to reduce overtreatment of this low-risk tumor that follows a benign course after surgery. Starting from a paradigmatic clinical case, in this short review, we will summarize the ultrasonography, cytological, histological and molecular features of this new entity. In the preoperative settings, the recognition of some peculiar elements may only suggest the possibility of a NIFTP, thus favoring a less aggressive surgical approach. However, the diagnosis of NIFTP can only be made after complete resection of the lesion by detecting well-defined inclusion and exclusion histopathological criteria. Since NIFTP is not 'malignant,' surgery may be considered curative with no further treatment or surveillance needed. NIFTP-related issues, including nodule size, multifocality, oncocytic changes, heterogeneous incidence across different geographical areas and its occurrence in the pediatric age, will be discussed.

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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in children and adolescents

Cited by 9 publications

References 12 publications

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): a review for clinicians

Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features in Children: An Institutional Experience and Literature Review

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: From Echography to Genetic Profile

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