Cytologically Indeterminate Follicular Thyroid Nodule on Fine Needle Aspiration Cytology is an Indication for Total Thyroidectomy.

The magnitude of case management of indeterminate thyroid nodule is very difficult and controversial. In addition there is recent evidence that the incidence of follicular lesion may be increasing that will prove to be follicular cancer. This prospective observational study was done in the department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from February 2016 to January 2017 to investigates the rate of malignancy and inability of demographical, clinical and sonographic data to predict malignancy in indeterminate nodules and the unreliability of intraoperative frozen section biopsy with the scope of determining the need for total thyroidectomy in these patients. The study population consisted of 40 cases presenting indeterminate nodules (Thy3): females (80%) and males (20%) with a mean age of 35.73±11.11 years. All patients underwent total thyroidectomy. Malignancy was diagnosed in 27 out of 40 patients (67.5%). The mean nodule size was 3.67±1.69mm in malignant lesions, 40.7% of the malignant nodules were more than 3cm in size, 51.9% of malignant cases were irregular border and 29.6% of malignant lesions were hard in consistency; these data are statistically significant (<0.05) and correlated with malignancy. The rate of malignancy in cytologically indeterminate lesions was high in the present study sample compared to other reported studies. Thus, considering the fact that demographical, clinical and sonographic features were found to be inaccurate predictors of malignancy, it is our opinion that total thyroidectomy should always be recommend in such patients.