1. Cosa fare nel nodulo citologicamente indeterminato? Paolo Bernante

2. Thy 3: follicular lesion This category usually accounts for 10-20% of thyroid cytologic reports

3. UOS CHIRURGIA ENDOCRINA METABOLICA E BARIATRICA Chirurgia Tiroidea ottobre 2008-settembre 2015

4. UOS CHIRURGIA ENDOCRINA METABOLICA E BARIATRICA 701 TIROIDECTOMIE INDICAZIONI

5. PATIENTS WITH AN FNA DIAGNOSIS OF FOLLICULAR NEOPLASM AND THEIR SUBSEQUENT FROZEN SECTION EVALUATION AND PERMANENT HISTOLOGY (Pelizzo, Bernante J.Exp.Clin.Cancer Res.,1998) 18 carcinomi (14,5%)

6. UOS CHIRURGIA ENDOCRINA METABOLICA E BARIATRICA 224 TIROIDECTOMIE (1/11/08 - 31/10/11) OUT OF 36 THY-3: 1 PTC (FOLLICULAR VARIANT) 2 FTC (MINIMALLY INVASIVE). MALIGNANCY RATE 8,3%

8. Thy 3 & Scintigraphy Nodules that are hot on scintigraphy should be excluded from FNA biopsy In follicular lesions, consider performing thyroid scintigraphy to exclude a hot nodule at very low risk for malignancy

9. Thy 3: follicular lesion Surgical excision is recommended for MOST follicular thyroid lesions (Grade B) Intraoperative frozen sections is not recommended as a routine procedure (Grade D) Consider clinical follow-up in the minority of cases with favorable clinical, US, cytologic, and immunocytochemical features (Grade D)

13. CASO CLINICO V.F. DONNA 27 aa

14. CASO CLINICO V.F. DONNA 27 aa.

17. CASO CLINICO V.F. DONNA 27aa QUALE SCELTA TERAPEUTICA ?

18. Thy 3A & decision making History (head & neck irradiation, family history of thyroid cancer) Age 70 years Male sex Growth rate, consistency, adenopathy, dysphonia US features & US Elastography Antibodies, calcitonin Molecular & immunohistochemical markers : at present are meant to complement and not replace clinical judgment, US and cytology PET (eccellente VPN per noduli > 1,5 cm; basso VPP) References: Thyroid 24:1115,2014; Endocrine Practice 20:360;2014