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Non-invasive follicular neoplasm with papillary-like nuclear features: a challenging and infrequent entity in Argentina

Abstract

Purpose

Non-invasive encapsulated follicular variant of papillary thyroid cancer was reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). These neoplasms have an extremely low malignant potential. The aim of this study was (1) to assess the prevalence of NIFTP in patients with papillary thyroid carcinoma, (2) to evaluate their outcomes, and (3) to determine their molecular profile.

Methods

Multicenter, descriptive, retrospective study. Patients with papillary thyroid cancer diagnosed from January 2006 to December 2016 from 11 referral centers were included. Diagnosis of NIFTP was based on criteria described by Nikiforov et al. in 2018. At least two pathologists agreed on the diagnosis. Two thousand six hundred and seventy-seven papillary thyroid cancer patients were included; 456 (17%) of them were follicular variant papillary thyroid cancer, and 30 (1.12%) fulfilled diagnostic criteria for NIFTP.

Results

Each of the 30 included patients underwent a total thyroidectomy, and 50% were treated with radioiodine (median dose 100 mCi). After a median follow-up of 37 months, 84% of patients had an excellent response, 3% had an indeterminate response and data was missing in the remaining 13%. No metastatic lymph nodes, distant metastases or recurrences were found. RAS mutations were detected in 4 patients (13%).

Conclusion

The prevalence of NIFTP in our series is amongst the lowest reported. Excellent outcomes of patients underscore their low malignant potential. Molecular findings differ from other series, probably related to environmental or ethnic features of our population and the meticulous criteria for diagnosing NIFTP.

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Acknowledgements

We thank the members of the Thyroid Department of Sociedad Argentina de Endocrinología y Metabolismo: Abalovich Marcos, Abelleira Erika, Alcaraz Graciela, Bielski Leila, Brenta Gabriela, Castro Jozami Lorena, Cavallo Andrea, Corino Mirta, Faure Eduardo, Frascaroli Genoveva, Gauna Alicia, Guerra Jorgelina, Gutierrez Silvia, Ilera Verónica, Iorcansky Sonia, Löwenstein Alicia, Martínez Maria, Moldes Sofia, Negueruela Maria, Oneto Adriana, Orlandi Ana, Parisi Carina, Reyes Adriana, Rosemblit Cinthia, Russo Picasso Maria, Sala Mónica, Sartorio Gerardo, Schnitman Marta, Silva Croome Maria, Sklate Rosana, Storani Maria, Vazquez Adriana, Zund Santiago, Zunino Anabela.

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Correspondence to Melina Sabán.

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Sabán, M., Tolaba, N., Orlandi, A.M. et al. Non-invasive follicular neoplasm with papillary-like nuclear features: a challenging and infrequent entity in Argentina. Endocrine (2022). https://doi.org/10.1007/s12020-022-03115-7

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Keywords

  • NIFTP
  • Follicular variant of papillary thyroid cancer
  • Thyroid neoplasm
  • Molecular analysis