Factors predictive of malignancy in thyroids: Indeterminate extemporaneous examination

Extemporaneous histological examination is of major importance in thyroid surgery. In the event of an inconclusive response, the identification of factors predictive of malignancy can help in the therapeutic decision. The objectives of this study are to determine the factors that may point to the malignancy of a thyroid nodule, and to discuss the current role of extemporaneous examination in the management of thyroid nodules (TN), through a retrospective, descriptive and analytical study carried out over a 4-year period on 100 cases of thyroid surgery patients whose extemporaneous examination was inconclusive. Bethesda 5 thyroid cytology and suspicion of NIFTP on extemporaneous examination were the only factors significantly correlated with malignancy in this series. None of the epidemiological, clinical or ultrasonographic factors classically reported in the literature as predictive of NT malignancy is completely specific, and their sensitivity is low and variable. The place of extemporaneous examination in thyroid pathology is still a matter of debate, especially in an era of rapid advances in molecular biology.