Hemithyroidectomy seems to be a reasonable initial surgical approach in patients with cytological bethesda category III thyroid nodules: An institutional experience

Abstract

Objective: The atypia of undetermined significance or follicular lesion of undetermined significance is a heterogeneous category of Bethesda system. This study aimed to evaluate the malignancy rates in the initial operation and contralateral thyroid lobe after completion thyroidectomy in patients with atypia of undetermined significance/FLUS thyroid nodules who underwent hemithyroidectomy. Material and Methods: We reviewed the medical records of 47 (7 male, 40 female; mean age 40.3±13.3 years) patients with cytological atypia of undetermined significance/ follicular lesion of undetermined significance nodules (total 48 nodules). Results: The preoperative cytology was evaluated as atypia of undetermined significance in 32 (66.7%) nodules and follicular lesion of undetermined significance in 16 (33.3%) nodules. The histopathology was reported as benign in 34 (72.3%) patients and malignant in 13 (27.7%) patients. Out of these 13 patients, complementary thyroidectomy was performed in 11 (23.4%) patients, of which 9 (81.8%) patients had benign histopathology and 2 (18.2%) had malignant histopathology. Conclusion: Lobectomy seems to be a reasonable initial surgical approach in patients with atypia of undetermined significance/follicular lesion of undetermined significance thyroid nodules in cytology.