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Fine needle aspiration biopsy limits preoperative assessment in medullary thyroid cancer
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Fine needle aspiration is an important diagnostic tool, but its low sensitivity limited preoperative evaluation in medullary thyroid cancer, according to study results.
This study was a retrospective chart review of 245 patients who underwent fine needle aspiration biopsy (FNAB) and were eventually diagnosed with sporadic medullary thyroid cancer (MTC).
“In our series, 245 [sporadic] MTC patients underwent FNAB, and the cytological findings suggested MTC or possible MTC in only 45.7%. Thus, the majority of [sporadic] MTC patients in our series would not be expected to receive an optimal preoperative evaluation or initial operation if decision making were based on their FNAB cytology alone,” Garth F. Essig Jr., MD, of Ohio State University, and colleagues wrote. “FNAB is an important diagnostic tool in the evaluation of thyroid nodules, but the low sensitivity of cytological evaluation alone in [sporadic] MTC limits its ability to command an optimal preoperative evaluation and initial surgery in over half of affected patients.”
Of the patients studied, 113 (46.1%) with surgical pathology revealing sporadic MTC had FNAB findings supporting the recommended treatment for MTC, which is total thyroidectomy with central neck dissection, and 37 patients (15.1%) had findings supporting total thyroidectomy alone. Diagnostic hemithyroidectomy was recommended in 32.7% of findings, and observation was recommended in 6.1%.
“Lower diagnostic accuracy may lead to misdiagnosis and suboptimal initial treatment or to a significantly delayed diagnosis if surgery is deferred,” the researchers wrote.
Disclosure: Essig reports no relevant financial disclosures. Please see full study for other researchers’ disclosures.
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