Objective: To evaluate the contribution of ultrasonography and frozen-section analysis (FS) in the prediction of malignancy in thyroid nodules with suspicious papillary thyroid carcinoma (PTC) cytology.
Methods and Results: The sample consisted of 89 patients with thyroid nodules diagnosed as suspicious for PTC by fine-needle aspiration cytology. Histology revealed malignancy in 69 of 89 patients (77.5%). Malignancy was observed in 55 of 58 nodules (94.8%) with suspicious ultrasonographic findings versus 14 of 31 (45.1%) without suspicious characteristics (P < 0.05). In 69 patients, FS revealed malignancy. Of them, 66 (95.6%) were found to be true carcinoma. In 17 of 20 patients (85%) with FS showing no malignancy, the nodule was confirmed to be benign.
Conclusion: Total thyroidectomy is indicated when a thyroid nodule with suspicious PTC cytology exhibits suspicious ultrasonographic characteristics or when FS reveals malignancy. Otherwise, lobectomy should be the initial procedure in cases of nonsuspicious ultrasonographic findings and absence of malignancy upon FS.