Thy 3F and 3a malignancy rate, a multisite regional retrospective case series

Abstract

Introduction The aim of this study was to ascertain the incidence of thyroid cancer for patients categorised as Thy3, 3a or 3f across four tertiary thyroid multidisciplinary centres in the UK. Material and methods This is a retrospective case series examining patients who presented with a thyroid nodule and diagnosed as Thy3, 3a or 3f according to the Royal College of Pathologists modified British Thyroid Association and Royal College of Physicians Thy system. Results In total, 395 patients were included in this study. Of these, 136 turned out to have benign thyroid disease and 24 had micropapillary thyroid carcinomas. The overall rate of thyroid malignancy was 28.8%. For each subcategory, the rate of malignancy was Thy3 24.7.7%, Thy3a 30.4% and Thy3f 29.2. However, the incidence of thyroid malignancy varied considerably between the four centres (Thy 3f 18-54%). Discussion The diagnosis of thyroid cancer is evolving but detection for malignancy for indeterminate nodules remains below 50% for most centres around the world. In 2014, the British Thyroid Association subdivided the original Thy3 category into Thy3a and Thy3f and recommended a more conservative approach to management for Thy3a nodules. Despite this, only two centres yielded a higher conversion rate of malignancy in the new higher graded Thy3f group compared with Thy3a. Conclusion It is debateable whether the new 'Thy3' subcategories are more useful than the original. Local thyroid malignancy rates may also be more useful than national averages to inform treatment decisions.

Risk of malignancy in the various categories of the UK Royal College of Pathologists Thy terminology for thyroid FNA cytology: A systematic review and meta‐analysis

“…Alexander [11], Mihai [12], Tysome [13], Dutta [14], Lakhani [15], Pagni [16], Wong [17], Rago [18], Brophy [19], Trombetta [20], Giusti [21], Khalil [22]. Finally, 13 articles; Agrawal [23], Dallari [24], Deandrea [25], Doddi [26], Fadda [27], Gill [28], Glynn [29], Kelly [30], Lobo [31], Mehanna [32], Montgomery [33], Mullen [34] and Parkinson [35] were included in the present systematic review and meta-analysis.…”

Is sonographic intra-nodular vascularity a reliable predictor of thyroid malignancy? A UK tertiary centre study

“…7,8,9 Notably, this group had a 50.4 per cent malignancy rate which at first glance appears more significant than the commonly quoted 25-30 per cent malignancy rate for thy3f nodules, many of which will undergo diagnostic excision. 10,11 However, in our series, all nodules had one or more additional features suspicious enough to warrant surgery (e.g. solid nodule, equivocal echogenic foci, disrupted peripheral calcification, microcalcification, presence of pathological lymph nodes, hypoechogenicity, 'taller-than-wide').…”

An H-TERT Mutated Skin Metastasis as First Occurrence in a Case of Follicular Thyroid Carcinoma

“…It is not clear whether the subdivision of Thy 3 lesions into Thy 3a (atypical features) and Thy 3f (follicular lesion) indicates a different oncologic risk, as suggested in the latest version of the BTA classification 3 . Alexander et al did not observe a real difference in risk, their rates of malignancy being 24.7.7% in Thy 3, 30.4% in Thy 3a, and 29.2% in Thy 3f (10). However, the incidence of thyroid malignancy varied considerably among the four centers involved in their study (Thy 3f 18–54%).…”