Castellanos, Paula

Abstract Disclosure: P.L. castellanos: None. A.M. Chindris: None. S. Rao: None. J. Janus: None. R. Paz-Fumagalli: None. V.J. Bernet: None. Introduction: Limited information exists regarding the relationship between outcomes and decision-making based on results from Ultrasound-guided fine needle aspiration (USG-FNA) of cervical nodes/nodules suspicious for thyroid cancer metastases. Management options for positive findings include surgery, percutaneous ethanol ablation, radioactive iodine therapy, external beam radiation systemic therapy, or observation. This retrospective review is aimed at describing the management and associated outcomes of a cohort of thyroid cancer patients who underwent USG FNA for cervically metastases. Methods: Following our Clinic IRB review and approval, we performed a chart review and identified 163 patients with thyroid cancer patients who had undergone USG FNA of apparent cervical metastases at the Florida campus between 2012 and 2018. Cytology results and corresponding tumor marker washout from each sampled focus were recorded. The records review included recording anatomical and biochemical outcomes related to management decisions based on USG FNA results. Appropriate statistical plots were used to help visualize the data pattern. ResultsThe median age was 59 years 69.9% were female and 91.3% were Caucasian. Initial presentation typically consisted of the appearance of a neck nodule and thyroidectomy was the first line of therapy in 155 of 163 cases. Imaging post-thyroidectomy demonstrated evidence of cervical lymphadenopathy in 75.5% of cases with localization in the lateral neck in 65.2% and central in 19.2% respectively. Regarding USG-FNA outcomes, 46.2% yielded malignancy while 26% were benign. The most prevalent cytology was papillary thyroid cancer detected in 87.1%.Thyroglobulin washout was performed on all patients with a history of papillary variant thyroid carcinoma, with positive results reported in 8.3%. Ethanol ablation was the most used treatment for lymph node recurrence followed by neck surgery in 56.2%. During the follow-up, 14% of the patients who were TGAB+ remained so.Outcome trends were as follows: The combined anatomical and biochemical negative was 82.3%, while the combined anatomical and biochemical positive was 2.5%. The combined anatomical negative and biochemical positive was 7.6%, alongside the combined anatomical positive and biochemical negative was 7.6%. Conclusion: Of 163 thyroid cancer cases with cervical lymphadenopathy, 46% had cytology-proven presence of malignancy. These patients underwent either observation, PEA, or surgery.At follow up the majority of the patients were without anatomical and biochemical evidence of disease while about 7-8% were positive by one of the parameters and much fewer were positive for disease by both parameters. Presentation: 6/3/2024

Abstract Disclosure: P.L. castellanos: None. S.E. Meek: None. A.M. Chindris: None. V.J. Bernet: None. Approximately 250 cases of papillary thyroid cancer (PTC) within a thyroglossal duct cyst (TGDC) have been reported worldwide. The presence of PTC within a TGDC is rare representing less than 1 % of all TGDC cases. This report describes the case of a young male with PTC in a TGDC suspicious nodules. We present this case along with a review of the literature related to this very uncommon finding. Papillary thyroid carcinoma is a very rare disease but always should be considered when speaking of a mass at the level of the central neck. There is a considerable controversy regarding the role of thyroidectomy to treat thyroglossal duct cyst carcinoma since the treatment of choice is Sistrunk procedure and the only indications to make a thyroidectomy will be aggressive disease and more than 45 years old according to some articles but without any consensus now. With a cure rate of 95 % and recurrence rate of 3 -10 % when this cancer is treated by Sistrunk operation, it doesn’t seem necessary to do an extent surgery if there is not enough thyroid compromised. Long term follow up is necessary to exclude the development of thyroid cancer. Presentation Date: Saturday, June 17, 2023