A patient underwent fine needle aspiration cytology for multinodular goiter. The repo was suspicious for papillary thyroid carcinoma. What is the percentage of risk malignancy in this patient?
20%
57%
30%
41%
For multinodular goiters, the four largest nodules (>/= 1 cm diameter) should be biopsied to minimize the risk of missing a malignancy. When FNA cytology is "suspicious" for papillary thyroid carcinoma or Huhle cell neoplasm, the risk of malignancy is 57%. When FNA cytology is a "suspicious" for follicular carcinoma, the overall risk of malignancy is about 20-25%, and higher for patients who are much younger or older than age 50. Most patients with suspicious FNA cytology are advised to have surgery. Ref: Fitzgerald P.A. (2013). Chapter 26. Endocrine Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow, T.G. Berger (Eds), CURRENT Medical Diagnosis & Treatment 2014.