Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules

Sena Akça; Merve Çatak

doi:10.47582/jompac.1844038

Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules

Abstract

Aims: Management of Bethesda category III (atypia of undetermined significance/follicular lesion of undetermined significance, AUS/FLUS) thyroid nodules remains challenging due to their heterogeneous malignancy risk. Patients with a history of extrathyroidal malignancy represent a clinically distinct subgroup, yet data regarding malignancy outcomes in this population are limited. Methods: This retrospective study included 336 patients who underwent thyroid surgery between 2013 and 2023 with preoperative Bethesda category III cytology. Among them, 23 patients (6.7%) had a documented history of extra-thyroidal primary malignancy. Demographic characteristics, thyroid functional status, laboratory parameters, ultrasonographic findings, and history of extra-thyroidal malignancy were recorded. Suspicious ultrasound features were evaluated. Postoperative histopathology was used as the reference standard. Results: Overall, malignant pathology was identified in 101 patients (30.1%), while 235 patients (69.9%) had benign pathology. A history of extra-thyroidal malignancy was significantly more frequent in patients with malignant postoperative pathology compared with benign cases (10.0% vs 5.5%, p=0.008). Malignant cases were younger than benign cases (p<0.001), and suspicious ultrasonographic features were significantly associated with malignancy (p=0.003). Nodules ≤1 cm were more common in the malignant group (p=0.016). Thyroid hormone levels did not differ significantly between benign and malignant pathology groups. Within the subgroup of patients with extra-thyroidal malignancy, further comparisons between benign and malignant thyroid pathology did not reach statistical significance, likely due to limited sample size, and were therefore considered descriptive. Conclusion: In patients with Bethesda category III thyroid cytology, a history of extra-thyroidal malignancy was associated with a higher likelihood of malignant postoperative pathology. These findings suggest that patients with prior malignancy constitute a higher-risk subgroup and may benefit from a more individualized management strategy, including consideration of earlier surgical intervention after a single indeterminate cytology result.

Keywords

References

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Details

Primary Language

English

Subjects

Endocrinology

Journal Section

Research Article

Authors

Sena Akça
0009-0000-8572-2173
Türkiye

Merve Çatak ^*
0000-0003-2654-3911
Türkiye

Publication Date

February 20, 2026

Submission Date

December 17, 2025

Acceptance Date

January 5, 2026

Published in Issue

Year 2026 Volume: 7 Number: 1

DOI

https://doi.org/10.47582/jompac.1844038

IZ

https://izlik.org/JA82SM65TH

Cite

RIS / Bibtex

APA

Akça, S., & Çatak, M. (2026). Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules. Journal of Medicine and Palliative Care, 7(1), 20-25. https://doi.org/10.47582/jompac.1844038

AMA

1.Akça S, Çatak M. Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules. J Med Palliat Care / JOMPAC / jompac. 2026;7(1):20-25. doi:10.47582/jompac.1844038

Chicago

Akça, Sena, and Merve Çatak. 2026. “Extra-Thyroidal Malignancy History and Postoperative Malignancy in Bethesda Category III Thyroid Nodules”. Journal of Medicine and Palliative Care 7 (1): 20-25. https://doi.org/10.47582/jompac.1844038.

EndNote

Akça S, Çatak M (February 1, 2026) Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules. Journal of Medicine and Palliative Care 7 1 20–25.

IEEE

[1]S. Akça and M. Çatak, “Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 1, pp. 20–25, Feb. 2026, doi: 10.47582/jompac.1844038.

ISNAD

Akça, Sena - Çatak, Merve. “Extra-Thyroidal Malignancy History and Postoperative Malignancy in Bethesda Category III Thyroid Nodules”. Journal of Medicine and Palliative Care 7/1 (February 1, 2026): 20-25. https://doi.org/10.47582/jompac.1844038.

JAMA

1.Akça S, Çatak M. Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules. J Med Palliat Care / JOMPAC / jompac. 2026;7:20–25.

MLA

Akça, Sena, and Merve Çatak. “Extra-Thyroidal Malignancy History and Postoperative Malignancy in Bethesda Category III Thyroid Nodules”. Journal of Medicine and Palliative Care, vol. 7, no. 1, Feb. 2026, pp. 20-25, doi:10.47582/jompac.1844038.

Vancouver

1.Sena Akça, Merve Çatak. Extra-thyroidal malignancy history and postoperative malignancy in Bethesda category III thyroid nodules. J Med Palliat Care / JOMPAC / jompac. 2026 Feb. 1;7(1):20-5. doi:10.47582/jompac.1844038