Objective: Since the ultrasonography (US) examination and fine-needle aspiration (FNA) biopsy have been used in the clinicopathological evaluation of thyroid pathology, a progressive increase in the prevalence of incidental micropapillary carcinomas (IMC) has been reported. Here, we investigated the predictive factors of suspicious malignancy of thyroid nodules increasing with age.

Methods: A retrospective review of data of 173 patients who underwent FNA biopsy and subsequent thyroidectomy in the Clinic of General Surgery University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital between December 2016-December 2019 years.

Results: The mean age of the patients was 46.7±22.6 (18-80). Most of the patients underwent total thyroidectomy (90.8%) based on the indication of FNA (47.4%) and toxic goiters (26.6%). The 76 patients were euthyroid (43.9%). The US showed that the hypoechogenicity and loss of the halo were the most common findings (60.1% and 57.8%, respectively). The number of patients more than 45 years who showed an irregular margin in the thyroid nodule was higher than younger patients (p=0.016). Although malignancy was mostly observed in young patients (100% vs. 87.5%, p=0.0022), IMC was seen more in older patients (33, 38.8% vs. 45, 51.1%, p=0.104). The loss of Halo and type of surgery had a significant effect on the presence of incidental carcinoma (odds ratio: 0.307 and 14.428, p=0.014 and 0.0026, respectively).

Conclusion: The old age, type of surgery, radiological findings including the loss of Halo might have a potential impact on the presence of IMC in the preoperative assessment of nodules regarding the management of surgical procedure.