Colloid Goiter Research Articles

Experience of applying convolutional neural network for binary classifcation of microphotographs of thyroid cytology specimens

Objective: to evaluate the effectiveness of a convolutional neural network model for automated cytologic diagnosis of papillary thyroid cancer and benign thyroid nodules.Material and Methods. The convolutional neural network was developed in the Python programming language using the TensorFlow 2.15.0 open source library. For the study, a dataset that included two categories of pathologies was generated: 1597 microphotographs of papillary carcinoma and 767 microphotographs of benign nodules (colloid goiter and adenomatous nodules). To form a training sample and evaluate the model’s performance metrics on the test sample, the dataset was divided in a ratio of 80/20.Results. In classifying papillary carcinoma, the model achieved precision of 89.3 %, recall of 92.4 %, specifcity of 77.4 % and F1 score of 91.4 %. When identifying benign nodules, the presicion, recall, specifcity and F1 score were 83.3 %, 77.4 %, 92.4 %, and 80.3 %, respectively, indicating a higher rate of false-positive and false-negative predictions. The AUC was 0.91 at the individual microphotograph level and 0.94 at the serial microphotograph level from one patient, indicating the high ability of the trained model to differentiate between malignant and benign thyroid lesions based on microphotographs of fne-needle aspiration biopsy specimens.Conclusion. Further improvement of the neural network model by training on larger and more diverse datasets of microphotographs of cytological specimens of the thyroid gland will help improve its diagnostic range and performance. The developed model can be used to develop software for identifying thyroid pathologies.

Efficacy of Follicular Cell Pattern Analysis in Thyroid Fine-needle Aspiration Cytology Evaluation.

Fine-needle aspiration cytology (FNAC) is widely utilized for thyroid lesion diagnosis but faces challenges such as sample inadequacy and overlapping cytological features. This study examines how accurately these patterns correlate with histopathological diagnoses, shedding light on FNAC's limitations and diagnostic potential. To study the application of the architectural pattern of follicular cells in the interpretation of thyroid lesions and to demonstrate the diagnostic accuracy (DA) of FNAC. Cross-sectional study carried over 1 year. A total of 110 cases were reviewed by the cytopathologists. The prominent follicular cell architecture, namely macrofollicular, microfollicular, papillary, trabecular, three-dimensional clusters, and dispersed cells, was described in each case. In addition to these patterns, cellular morphology and background features were also noted, and a final cytological diagnosis was established. The cytology diagnosis was correlated with the histopathological diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, DA of FNAC in diagnosing nonneoplastic and neoplastic lesions. Macrofollicular pattern was seen in 80.26% of colloid goiter cases. Microfollicular pattern was observed in 72.2% of follicular neoplasm. About 62.5% of papillary thyroid carcinomas showed a papillary pattern. The trabecular pattern was seen in 42.86% of chronic lymphocytic thyroiditis and 16.67% of follicular neoplasms. The sensitivity and specificity of FNAC in diagnosing neoplastic lesions was 92.59% and 97.59%, respectively. FNAC is a simple, rapid, definite, and cost-effective primary diagnostic tool for thyroid evaluation. Cell architecture pattern is a simple and appropriate approach that complements cell morphology and background details in arriving at the final cytological diagnosis of thyroid lesions.

The Impact of Thyroid Surgery on Calcium and Magnesium Homeostasis: A Prospective Study.

Total thyroidectomy constitutes one of the bread-and-butter procedures of surgeons all over the world. Like with any surgical procedure, complications form a part and parcel of the postoperative course in the hospital. Hypocalcemia represents one such prevalent complication post-total thyroidectomy. This study aimed to evaluate the impact of total thyroidectomy on calcium and magnesium levels and to assess the role of magnesium in postoperative hypocalcemia. This study was carried out at a tertiary health center over a two-year period from 2022 to 2024. It involved 100 participants with thyroid conditions (benign/malignant) who required total thyroidectomy. Patients with pre-existing conditions affecting calcium levels (e.g., chronic renal failure, medullary carcinoma thyroid, etc.) were expressly excluded.Preoperative calcium, magnesium, and parathyroid hormone (PTH) levels were recorded. Intraoperative parameters such as time and fluid volume were also measured. Postoperatively, serum calcium and magnesium levels, PTH levels, and complications like hypocalcemia and hypomagnesemia were monitored. The descriptive statistics were computed to delineate the study sample. After completion of data collection, data analysis was achieved using IBM SPSS Statistics for Windows, V. 16.0 (SPSS Inc., Chicago, IL). The chi-squared test of significance was utilized to establish statistical correlations between calcium and magnesium levels post-total thyroidectomy. A p-value of less than 0.05 was considered statistically significant. The study analyzed 100 total thyroidectomy patients. The mean age of patients in our study was 50.7±8.86 years, with 97 females and three males. The most common pathology indicating total thyroidectomy was diffuse colloid goiter (46%), followed by multinodular goiter (38%). Only a single patient had preoperative biochemical hypocalcemia or hypomagnesemia, but none exhibited symptoms. After total thyroidectomy, 15% (n=15) developed hypocalcemia, and 11% (n=11) developed hypomagnesemia. Postoperative mean PTH levels slightly decreased to 28.8±11.75 pg/dl, indicating similar variability to preoperative levels. Patients who underwent intra-capsular dissection had a mean postoperative ionic calcium level of 4.89±0.54 mg/dl, while those who underwent extra-capsular dissection had a slightly lower mean ionic calcium level of 4.72±0.76 mg/dl. Hypocalcemia is one of the most prevalent complications associated with total thyroidectomy. The role of magnesium in maintaining calcium homeostasis after thyroidectomy should be further explored to improve the management of hypocalcemia. Additionally, the type of capsular dissection performed during the surgery can impact the occurrence of hypocalcemia, and using intra-capsular dissection whenever possible may help reduce the incidence of hypocalcemia.

Intrathyroidal Parathyroid Adenoma - An Incidental Diagnosis.

Aim This case report highlights the importance of preoperative assessment of calcium in all cases of thyroid surgery. Intrathyroidal parathyroid adenoma (IPA) is a rare presentation of primary hyperparathyroidism. It is caused by abnormal embryonic migration of parathyroid glands and is difficult to detect preoperatively. When diagnosed pre operatively it has good surgical outcome. Herein authors present a case of thirty-two-year lady who underwent hemithyroidectomy for colloid goitre and was detected to have intrathyroidal parathyroid adenoma (IPA) on histopathological examination.

Thyroid tuberculosis mimicking multinodular goiter: a case report

BackgroundMycobacterium tuberculosis is the second most common infectious cause of death in adults worldwide. The ability of this organism to efficiently establish latent infection has enabled it to spread to nearly one-third of individuals worldwide. Approximately 8 million new cases of active tuberculosis disease occur each year, leading to about 1.7 million deaths. The disease incidence is magnified by the concurrent epidemic of human immunodeficiency virus infection. A total of 1.3 million people died from tuberculosis in 2022. In 2022, an estimated 10.6 million people fell ill with tuberculosis worldwide, including 5.8 million men, 3.5 million women, and 1.3 million children. We report a case of thyroid tuberculosis presenting as multinodular goiter. Neck ultrasound was done and revealed abscess collection on the background of multinodular colloid goiter. The diagnosis of thyroid tuberculosis was confirmed by a positive GeneXpert of the pus sample and the presence of extensive caseous necrosis on cytopathology examination. Furthermore, anterior neck swelling may provide a diagnostic challenge by clinically mimicking multinodular goiter or thyroid neoplasms. Owing to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report it.Case presentationA 60-year-old retired female Ethiopian high-school teacher presented to University of Gondar Hospital, Gondar, Ethiopia with firm, nontender multinodular anterior neck swelling measuring at largest 2 × 3 cm that moves with swallowing. GeneXpert of the pus sample and cytopathology examination confirmed the diagnosis of thyroid tuberculosis, and the patient was started on 2 rifampicin−ethambutol−isoniazid−pyrazinamide/4 rifampicin−isoniazid 3 tablets by mouth/day, which is defined as the preferred first-line anti-tuberculosis regimen in Ethiopia, and pyridoxine 50 mg by mouth per day for 6 months. Since then, she has been followed with regular liver function tests. The patient has shown a smooth course with no significant adverse effects encountered. Currently, the patient has completed her anti-tuberculosis treatment and is doing well.ConclusionIn the clinical evaluation of a patient with anterior neck swelling, tuberculosis must be considered as a differential diagnosis in subjects from endemic areas for early diagnostic workup and management.

A Postmortem Finding of a Colloid Goiter in an American Black Bear (Ursus Americanus)

Abstract The present case report aims to describe a postmortem finding of a colloid goiter, without obvious clinical signs of endocrine disease in a 30-year-old American black bear (Ursus americanus) from the “Zoo” in the city of Sofia, Bulgaria. A clinical examination due to a bad general condition was performed under anesthesia and a computed tomography was conducted. After the established irreversible spondylarthrosis changes the bear was euthanized. Postmortem, the thyroid gland was pathologically examined and typical findings for a colloid goiter were observed. Hibernating mammals such as the American black bear have been shown to enter a state of physiological hypothyroidism during hibernation. Hormonal signals from the thyroid gland have been suggested to be a key mediator of hibernation. From the presented case could be assumed that the captive life conditions and the prolonged life of the zoo bears may affect the function of their thyroid gland.

A COMPARATIVE ANALYSIS OF THYROID CYTOLOGY CLASSIFICATION SYSTEMS: BETHESDA SYSTEM VERSUS FRCPATH, AUSTRALIAN, JAPANESE, AND ITALIAN APPROACHES IN THE INDIAN CONTEXT

Objectives: There are many different popular coding systems in use across the world such as Bethesda, FRCPath (UK), the Australian reporting system, the Japanese Thyroid Reporting System, and the Italian classification system. By evaluating the strengths and weaknesses of each system concerning the Indian patient population and health-care infrastructure, this study aims to identify the most suitable approach for accurate thyroid cytology reporting and patient management in India. Methods: A retrospective cohort study was conducted at a tertiary care center in central India following due ethical clearance. A total of 208 cases met the inclusion criteria of this study. The clinical records and the cytological records of these cases were independently analyzed and reclassified by a group of pathologists into all the above-stated thyroid coding systems. Data were collected and analyzed using Microsoft Excel 2016. Results: Approximately 88.46% of the cases were women. Medial lobe was the most common site with prevalence of 80.29%. Colloid goiter is most common cytological diagnosis. Only for 11 cases, there was a difference in coding among these coding systems. Codes 1 and 2 are same in all the coding systems and the main difference identified for cases with Bethesda Codes 3 and 5. Conclusion: The Bethesda coding is simple and reliable for coding thyroid FNAC as it has been reported over the period. The other coding systems can also be used but they will have their long learning curve. Furthermore, Bethesda is being used universally making the report understandable.

Ectopic colloid goiter in mediastinum with normal thyroid gland

Ectopic thyroid tissue is a rare developmental abnormality involving aberrant embryogenesis of the thyroid gland during passage from the primitive foregut to the pretracheal position. The most frequent position is the base of the tongue (lingual thyroid); however, it has been described in other sites, such as the submandibular region, trachea, mediastinum, and subdiaphragmatic regions.Here, we report a case of an adenomatous goiter that developed in mediastinal thyroid tissue without any connection to the pretracheal thyroid gland.

Near-Infrared Spectroscopy for Distinguishing Malignancy in Thyroid Nodules.

Thyroid nodules are common clinical entities, with a significant proportion being malignant. Early, accurate, and non-invasive tools to differentiate benign and malignant nodules can optimize patient management and reduce unnecessary surgery. This study aimed to evaluate the efficacy and accuracy of near-infrared spectroscopy (NIRS) in distinguishing benign from malignant thyroid nodules. A diffuse reflectance spectrum for a total of 20 thyroid nodule samples (10 samples as colloid goiter and 10 samples as thyroid cancer), were acquired in the wavelength range from 1000 to 2500 nm. Spectral data from NIRS were analyzed by means of principal component analysis (PCA), quadratic discriminant analysis (QDA), and linear discriminant analysis (LDA) to classify and differentiate thyroid nodule samples. The present study found that NIRS effectively distinguished colloid goiter and thyroid cancer using the first two principal components (PCs), explaining 90% and 10% of the variance, respectively. QDA discrimination plot displayed a clear separation between colloid goiter and thyroid cancer with minimal overlap, aligning with reported 95% accuracy. Additionally, applying LDA to seven PCs from PCA achieved a 100% accuracy rate in classifying colloid goiter and thyroid cancer from near-infrared spectral data. In conclusion, NIRS offers a promising, non-invasive complementing diagnostic tool for differentiating benign from malignant thyroid nodules with high accuracy. Future work should integrate these results into predictive model development, emphasizing external validation, alternative performance metrics, and protecting against potential overfitting translation of a machine learning model to a clinical setting.

An immobile thyroglossal duct cyst with tongue protrusion: A case report

The thyroglossal duct cyst is one of the most common lesions in the midline of the neck and is found in around 7% of the population. They often present as painless neck swellings that move in response to tongue protrusion and during deglutition. We describe a case of thyroglossal duct cyst that was atypical in that the cyst was distant from the midline, it did not move in response to tongue protrusion, and the swelling was significant that resembled a colloid goiter. A 36-year-old male presented to the surgical outpatient department with a complaint of painless swelling in the neck for the past year. A 6.5×4.5 cm2 swelling was observed in the anterolateral aspect of the right side of the neck extending to the thyroid notch. Neck ultrasound and fine needle aspiration cytology showed features suggestive of a thyroglossal duct cyst. The patient was prepared for the Sistrunk procedure for thyroglossal duct cyst excision. The patient was on regular follow-up postoperatively for 6 months, and no evidence of any recurrence was seen.

Thyroid surgery in children: a single-center experience of 20 years.

Thyroidectomy is a relatively uncommon procedure in pediatric patients. We aimed to review our 20-year experience of thyroid surgery. A total of 39 patients who underwent thyroid surgery from 2003 to 2023 were retrospectively evaluated. All patients were followed preoperatively and postoperatively by our institutional multidisciplinary board. Patients were divided into two groups based on their pathologies: benign and malignant. In total, 39 patients (27 girls and 12 boys) underwent 47 thyroid surgeries (total thyroidectomy in 19 patients and subtotal thyroidectomy in 20 patients, with 8 of them having completion thyroidectomy). Notably, 20 (51%) patients had benign and 19 (49%) patients had malignant pathologies. Median age at operation was 157 (9-223) months in the benign group and 182 (1-213) months in the malignant group. In the benign group, 12 (60%) patients had colloidal goiter and 8 (40%) patients had other conditions. In the malignant group, 12 (63%) patients had papillary thyroid carcinoma, 3 (16%) patients had follicular thyroid carcinoma, 2 (11%) had medullary thyroid carcinoma, and 2 patients had other thyroid malignancies. Overall permanent complication rate was 2 out of 39 (5%), which was similar for both groups (1 hypocalcemia in each group). The median follow-up was 38 months (1-179 months) with no local recurrence or distant metastasis. Pediatric thyroidectomies are performed on a heterogeneous group of pediatric patients due to a diverse group of pathologies. A multidisciplinary approach is required for proper initial management and surgical strategy with decreased complication rate and event-free survival of these patients in experienced tertiary centers.

A Case of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Mimicking Hashimoto’s Thyroiditis

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma (DSV-PTC) is a rare and aggressive subtype of Papillary Thyroid Carcinoma (PTC) The prognosis of this variant is as good as classic PTC, but close follow-up is necessary because of frequent tumour recurrence. The authors report a case of a 30-year-old female who presented with a 6-month history of gradually progressive midline neck swelling. Antithyroid antibodies were elevated, and radiology was suggestive of a colloid goitre. Total thyroidectomy was done along with anterior compartment lymph node removal for confirmation. Interestingly, histopathology showed a picture reminiscent of Hashimoto’s Thyroiditis (HT), but the lymph node showed tumour metastasis. Thereafter, additional sections were taken to establish the diagnosis of DSV-PTC in the thyroid. The present case highlights the importance of extensive sampling in histopathology for a suspected case of malignancy, as it can be misdiagnosed as a benign aetiology.

Papillary thyroid microcarcinoma: impossible to operate observe – where to put a comma?

Objective. To evaluate the efficiency of diagnostics and treatment in patients with microcarcinomas of the thyroid gland at the State Medical Institution "RCOD of the Ministry of Health of the Republic of Tatarstan named after Professor. M.Z. Sigal" for 2020-22.
 Materials and methods. MIS "BARS. Healthcare – MIS" of oncological dispensary, outpatient charts and medical histories of patients operated on for thyroid microcarcinomas were used.
 Results. In the study group, all patients had papillary microcarcinoma. Women over 45 years of age prevailed. Women of fertile age accounted for 41.7%. The combination of microcarcinoma with thyroid adenomas, colloidal goiter and AIT was detected in 78.6% of patients. The organ capsule invasion occurred in 35.7% of patients, metastases to regional lymph nodes – in 19%. Thyroidectomy was performed in 66.7% of patients; 12 (28.6%) patients underwent I-131 therapy.
 Conclusions. Due to the fact that papillary microcarcinoma of the thyroid gland is often found in women of fertile age, and develops against the background of another thyroid pathology complicating diagnostics, it sprouts an organ capsule in 35.7% and gives metastases to regional lymph nodes in 19%, therefore requires a timely diagnostics and radical treatment.

Parathyroid carcinoma case-report in a patient with multinodular goiter and chronic kidney disease: difficulties in diagnosis and treatment (observation from practice)

We would like to present a clinical case of severe primary hyperparathyroidism due to a parathyroid carcinoma of atypical location in a patient with chronic kidney disease of complex etiology and multinodular goiter. Patient S., 59 years old, was followed-up for a long time in tertiary referral hospitals for “chronic tubulointerstitial nephritis with nephrosclerosis”, secondary hyperparathyroidism due to chronic kidney disease (CKD) G3–4, osteoporosis, and a multinodular euthyroid colloid goiter. In July 2021 she was referred to the Endocrinology Research Centre in order to clarify the diagnosis because of the persistence of an extremely high level of parathyroid hormone (PTH) despite cinacalcet treatment. During examination, primary hyperparathyroidism, a left parathyroid gland lesion, multinodular goiter with subclinical thyrotoxicosis, and vitamin D deficiency were diagnosed. After the removal of the left parathyroid gland lesion (histologically confirmed parathyroid carcinoma) and a left-sided hemithyroidectomy, hypocalcemia («hungry bone syndrome») developed, but the level of parathyroid hormone remained elevated. After 3–18 months after surgery, no data for relapse of primary hyperparathyroidism was obtained. The persistent moderate increase in PTH was regarded as secondary hyperparathyroidism in CKD and hypocalcemia. Complex therapy of osteoporosis with the antiresorptive drug denosumab, vitamin D and its active metabolite, calcium preparations, and parathyroidectomy led to a significant increase in bone mineral density (BMD) and no repeated fractures 18 months after surgery.Conclusion. In patients with pre-dialysis CKD and high PTH levels, it is necessary to make a differential diagnosis between primary (PHPT) and secondary hyperparathyroidism (SHPT). Severe manifestations of primary hyperparathyroidism can be suspicious for parathyroid carcinoma.

Comparative Study of FNAC and Histopathology in Diagnosis of Thyroid Swelling

IntroductionFine Needle Aspiration Cytology (FNAC) is important for pre-operative and pre-treatment diagnosis of benign and malignant thyroid lesions, thus decreasing the incidence of unwanted surgeries. The objective of this research is to compare the FNAC and Histopathological findings of thyroid swelling.MethodsThe present study is a cross sectional study conducted on 30 patients in the Department of Otorhinolaryngology Head and Neck Surgery, College of Medical Sciences, Bharatpur, Nepal from January 2022 to December 2022. Thyroid swelling presented to OPD were examined clinically after thorough history taking and admitted to indoor and subsequently underwent surgery were included in this study. After Histopathology they were compared with preoperative FNAC report. In all cases, informed consent was taken prior to the surgery.ResultsFNAC shows thirteen (28.57%) non neoplastic and twenty-two (71.43%) neoplastic. Among non neoplastic thyroid swelling, colloid goiter was common. Among neoplastic thyroid swelling Papillary carcinoma was the most common. Cyto-histopathological correlation of 35 cases was done. Out of thirty-five cases fifteen (42.87%) were non neoplastic and twenty (57.15%) were neoplastic. Colloid goiter was most common. Sensitivity of our study was 88.24%, Specificity was 55.56 % and accuracy was 71.43%.ConclusionsFNAC is a quick, safe, and reliable first-line diagnostic test for thyroid nodules. However, histopathology is the gold standard for the diagnosis of thyroid cancer and provides detailed information on the tumor size, location, and histological type.

UTILITY OF ULTRASOUND ELASTOGRAPHY IN DIFFERENTIATING BENIGN FROM MALIGNANT THYROID NODULES

Background: Ultrasound elastography is an imaging technique used for the evaluation of tissue stiffness by measuring the degree of tissue deformation in response to the application of external force. Methodology: In this prospective comparative study, a total of 52 thyroid nodules from 44 euthyroid patients undergoing fine needle aspiration cytology (FNAC) were assessed. Elastography was performed by a single experienced sonologist, wherein the nodules were graded as per elastography scoring (ES), and the strain ratio (SR) for each nodule was computed. Final histopathology findings of the patients undergoing surgery were compared to elastography findings, and measures of diagnostic accuracy to differentiate between benign and malignant nodules were determined. Results: Thirty (68.2%) females and 14 (31.8%) males, with a mean age of 45.18±11.23 years, were assessed. Fourteen (31.8%) patients underwent thyroidectomy, and histopathology was reported for 18 (34.6%) nodules. In all, nine (17.3%) nodules were malignant, and 43 (82.7%) nodules were considered benign. ES demonstrated a sensitivity of 88.9%, specificity of 88.3%, PPV of 61.5% and NPV of 97.4% to identify benign thyroid nodules. The mean SR for benign nodules was significantly lower as compared to malignant nodules (2.72±0.62 vs. 4.52±0.75, P<0.0001). The optimal cut-point value for SR to differentiate benign and malignant thyroid nodules was determined to be 3.8, with the sensitivity, specificity, PPV, and NPV being 88.9%, 95.4%, 80%, and 94.6%, respectively. Of the six nodules classified as Bethesda category-III or IV on FNAC, histopathological diagnosis was follicular carcinoma in one nodule (Bethesda category-IV), four were diagnosed with follicular adenoma, and one with colloid goitre. The ES of the nodule with follicular carcinoma was malignant, while amongst the rest, two nodules were classified as benign, and three nodules as malignant. The SR of the follicular carcinoma was 4.3, while the mean strain ratio in remaining nodules was 3.48 (P=0.001). Conclusion: Ultrasound elastography has good diagnostic efficacy for the differentiation of benign from malignant thyroid nodules. It can potentially reduce the rates of unnecessary fine needle-aspiration biopsy. However, whether elastography score or strain ratio will be useful in diagnosis of nodules which are indeterminate on FNAC is open to further studies.

HISTOPATHOLOGICAL SPECTRUM OF THYROID LESIONS AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

Objective: The objective of the study is to determine the proportion of different patterns (colloid goiter, colloid cyst, papillary carcinoma, etc.) of thyroid lesions among the patients who have undergone surgical treatment. Methods: This was prospective and retrospective study to be conducted on 100 thyroidectomy specimens received in 5-year period (2016–2020) in Department of Pathology in Dr. S.N. Medical College, Jodhpur. Results: Age ranged from 10 days to 85-year-old, Peak incidence of thyroid diseases was seen in the third to fifth decade, 78% non-neoplastic lesion, Adenomatous goiter was the most common non-neoplastic lesion (65%), Papillary carcinoma was the most common malignant lesion encountered. Conclusion: Although non-invasive techniques like aspiration cytology provide a diagnosis in most, the ultimate answer often rests with histopathological examination of thyroidectomies, which forms the mainstay for a definitive diagnosis. Thorough gross and microscopic evaluation of thyroidectomies is mandatory even for non-neoplastic lesions as they sometimes harbor neoplasms.

THU674 Papillary Thyroid Carcinoma Presenting As A Benign Ectopic Thyroid Mass In The Anterior Mediastinum. A Case Report

Abstract Disclosure: M.V. David-santos: None. C. Narvacan-montano: None. Background: Ectopic Thyroid Tissue (ETT) is a rare developmental anomaly that is due to the failure of the thyroid gland to assume its position in front of the trachea. Ectopic Thyroid tissue in the mediastinum is very rare, with only a few cases reported in the literature. An incidental Papillary Thyroid Carcinoma presenting as a mediastinal mass that turns out to be benign ectopic thyroid cells is even rarer. Case: This is the case of a 33-year-old female who presented with sudden onset difficulty of breathing and chest heaviness. On workup, she was found to have an anterior mediastinal mass, which showed ectopic thyroid cells on biopsy. Further evaluation of the neck area revealed a 1.25 cm x 1 x 1.13 cm nodule on the thyroid gland which showed suspicious for Papillary Thyroid Carcinoma on Fine needle aspiration biopsy. The patient underwent Total Thyroidectomy and Excision of the Anterior Mediastinal Mass. The histopathologic report of the thyroid mass revealed a Conventional Unifocal Papillary Thyroid Carcinoma, while the excised tissues comprising the mediastinal mass were consistent with benign ectopic thyroid tissues with colloid goiter. Conclusion: The presence of the ectopic thyroid mass in the anterior mediastinum may be a potential area for metastasis. The final pathologic report nevertheless, categorizes this Papillary thyroid carcinoma as having a low risk of metastasis as per the American Thyroid Association Classification of 2015. Hence the conservative approach of Suppression therapy and active surveillance is the choice of management for this unusual case. Presentation: Thursday, June 15, 2023

SAT499 Amyloid Goiter: A Case Series

Abstract Disclosure: J. Paz-Ibarra: None. M. Concepción-Zavaleta: None. A.P. Solis Pazmino: None. J. Somocurcio Peralta: None. Background: Amyloid goiter (AG) is a rare presentation of thyroid swelling, characterized by the presence of deposits of amyloid protein in the thyroid tissue, accompanied by fat deposition or thyrolipomatosis. It may occur in 50% and up to 80% of patients with primary and secondary amyloidosis, respectively. Currently, the treatment is surgical resection of the thyroid gland. The present study reports a case series of primary thyroidal nodular amyloid goiter diagnosed by fine-needle cytology (FNC). Clinical cases:There were 2 female and 1 male patient from Peru. All three patients had comorbidities prior to AG diagnosis. F1: 65 years old, history of Rheumatoid Arthritis, Sjogren’s disease nephron Angio sclerosis, and polycystic kidney disease. F2: 67 years old, history of rheumatoid arthritis, end-stage renal disease (ESRD), arterial hypertension. M1: 28-year-old man with a history of pulmonary tuberculosis, bronchiectasis, and ESRD on HD due to renal amyloidosis of 9 years' evolution. They reported dyspnea, dysphagia, and dysphonia. On their physical examination, they had a bilateral, firm, and diffusely enlarged thyroid gland. Her serum T3, T4, and TSH levels were all normal. The PAAF reported a colloid goiter (Bethesda II). A total thyroidectomy was performed, with no complications. An alcohol-fixed smear was stained with Congo red: the amyloid material appeared cherry red and it also showed apple-green birefringence when observed with a polarizing microscope. Conclusions: Secondary amyloidosis generally has a neoplastic origin or is secondary to chronic inflammatory diseases. The development of a giant goiter with compressive symptoms is the most common form of presentation and represents amyloid infiltration of the gland. Total thyroidectomy is the method of choice for both diagnosis and treatment of amyloid goiter. Histological evaluation of the resected thyroid gland is crucial to make a definitive diagnosis. Presentation Date: Saturday, June 17, 2023

Profile and pattern of histology specimen of thyroidectomy patients operated in Mankweng hospital, Limpopo province, South Africa

Object of study: To evaluate the histopathologic pattern of the thyroidectomy specimen in patients with goitre who underwent thyroidectomy operation at Mankweng Hospital and to review the profile of thyroid disease in relation to the age, gender & Distribution of thyroid disease which are referred to Mankweng hospital from the districts of Limpopo Province.
 The problem to be solved: The demographic profile of thyroidectomy patients in this hospital is identified. Hence outreach program can be initiated according to demographic profile.
 Main scientific results: Total of 62 patients analyzed: Male 2, female 60. Age range 15-70: District: Capricorn 23, Sekhukhune 33, Mopani 6. Histology: 62: Multinodular goitre 47, Papillary carcinoma 5: Hurtle cell carcinoma 3, colloid goitre 2, Diffuse colloid goitre 1, Cavernous haemangioma 1, follicular neoplasm 1, Hashimoto`s Thyroiditis 1, benign thyroid parenchyma with cyst 1
 The area of practical use of research results: General surgery department in Regional & Tertiary hospital
 An innovative technological product: Patient demographic profile for health outreach program.
 Scope of application of an innovative technological product: General surgery department.