Familial non-medullary, follicular cell-derived thyroid neoplasms represent a genetically diverse and under-recognized group of tumors arising from follicular epithelial cells. These familial thyroid tumors are subclassified into syndromes where thyroid tumors represent the major disease manifestation and syndromes with a predominance of non-thyroid neoplasms. Among the latter group, germline mutations in the DICER1 and PTEN genes are increasingly implicated in syndromic forms of follicular-derived thyroid disease. DICER1 syndrome and PTEN-hamartoma tumor syndrome, encompassing Cowden syndrome and related entities, confer a high organ-specific predisposition to benign and malignant thyroid lesions. Both syndromes demonstrate distinctive clinicopathologic patterns, including early-onset thyroid follicular nodular disease, multifocal follicular adenomas, and increased risk for thyroid malignancies. Recognizing clinical, anatomical, and histomorphological clues when evaluating thyroid specimens (particularly bilateral nodules, multinodularity, histologically distinct neoplasms, multiple adenomatous nodules, macrofollicular pattern, oncocytic features, unusual adenoma subtypes, young male gender, or early presentation) can prompt genetic evaluation. Here, we review the molecular pathogenesis, clinical features, histologic spectrum, and diagnostic strategies associated with familial follicular cell-derived thyroid tumors caused by DICER1 and PTEN germline alterations. Increased awareness of these entities by pathologists and clinicians is critical to ensure timely diagnosis, risk-appropriate surveillance, and cascade testing in affected families.

Introduction: Ki-67 has shown promise as a predictive and diagnostic marker in solid tumours. The Ki-67 index is a wellestablished proliferation marker that has been studied in various tumours, including follicular neoplasms of the thyroid. Its role in thyroid pathology, especially in differentiating between Follicular Thyroid Adenoma (FTA) and Follicular Thyroid Carcinoma (FTC), has garnered significant clinical interest. Aim: To evaluate the diagnostic and prognostic utility of the Ki-67 labeling index (Ki-67 LI) in follicular neoplasms of the thyroid. Materials and Methods: A comprehensive search of records in the databases PubMed, Embase, and Scopus, along with manual citation searching, was conducted using MeSH terms and keywords related to ‘Ki-67 antigen’ and ‘FTC.’ Peerreviewed literature evaluating Ki-67 as a diagnostic or prognostic marker in follicular thyroid neoplasms published in English was included. Non English publications, reviews, case reports, and editorials, as well as research focusing solely on other thyroid cancers, including anaplastic or medullary carcinomas, were excluded during the screening process. The quality assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) Cochrane tool and the Quality in Prognosis Studies (QUIPS) for diagnostic and prognostic studies, respectively. A narrative synthesis and subgroup analysis of the extracted data were performed due to the heterogeneity in effect measures of Ki-67 labeling index and the outcomes. The parameters of prognostic outcomes assessed included the proportion of metastasis, recurrence, nodal involvement, survival rates, and mortality rates. The parameters of diagnostic outcomes involved the mean/median Ki-67 index to differentiate benign from malignant neoplasms. Results: A total of six eligible studies were included in this review. Follicular carcinomas demonstrated significantly higher Ki-67 labeling indices compared to adenomas. High values of Ki-67 are associated with malignancy, tumour aggressiveness, recurrence, and metastasis. The subgroup analysis indicated that the likelihood of poor prdeognosis for follicular thyroid neoplasms is approximately doubled at a cut-off of about 5% for the Ki-67 LI. Conclusion: This review includIntroduction: Ki-67 has shown promise as a predictive and diagnostic marker in solid tumours. The Ki-67 index is a wellestablished proliferation marker that has been studied in various tumours, including follicular neoplasms of the thyroid. Its role in thyroid pathology, especially in differentiating between Follicular Thyroid Adenoma (FTA) and Follicular Thyroid Carcinoma (FTC), has garnered significant clinical interest. Aim: To evaluate the diagnostic and prognostic utility of the Ki-67 labeling index (Ki-67 LI) in follicular neoplasms of the thyroid. Materials and Methods: A comprehensive search of records in the databases PubMed, Embase, and Scopus, along with manual citation searching, was conducted using MeSH terms and keywords related to ‘Ki-67 antigen’ and ‘FTC.’ Peerreviewed literature evaluating Ki-67 as a diagnostic or prognostic marker in follicular thyroid neoplasms published in English was included. Non English publications, reviews, case reports, and editorials, as well as research focusing solely on other thyroid cancers, including anaplastic or medullary carcinomas, were excluded during the screening process. The quality assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) Cochrane tool and the Quality in Prognosis Studies (QUIPS) for diagnostic and prognostic studies, respectively. A narrative synthesis and subgroup analysis of the extracted data were performed due to the heterogeneity in effect measures of Ki-67 labeling index and the outcomes. The parameters of prognostic outcomes assessed included the proportion of metastasis, recurrence, nodal involvement, survival rates, and mortality rates. The parameters of diagnostic outcomes involved the mean/median Ki-67 index to differentiate benign from malignant neoplasms. Results: A total of six eligible studies were included in this review. Follicular carcinomas demonstrated significantly higher Ki-67 labeling indices compared to adenomas. High values of Ki-67 are associated with malignancy, tumour aggressiveness, recurrence, and metastasis. The subgroup analysis indicated that the likelihood of poor prdeognosis for follicular thyroid neoplasms is approximately doubled at a cut-off of about 5% for the Ki-67 LI. Conclusion: This review included six studies involving retrospective analysis. There are variations in the techniques of immunohistochemical analysis, cell counting methods, and cut-off values chosen for the Ki-67 index among the included studies. Due to a lack of consensus regarding the reliability and standardisation of this biomarker, Ki-67 LI cannot replace standard histology. Regardless of a specific threshold, high Ki67 levels effectively differentiate carcinomas from adenomas and indicate a poor prognosis.ed six studies involving retrospective analysis. There are variations in the techniques of immunohistochemical analysis, cell counting methods, and cut-off values chosen for the Ki-67 index among the included studies. Due to a lack of consensus regarding the reliability and standardisation of this biomarker, Ki-67 LI cannot replace standard histology. Regardless of a specific threshold, high Ki67 levels effectively differentiate carcinomas from adenomas and indicate a poor prognosis.

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a recently recognized thyroid tumour entity with indolent behaviour and extremely low malignant potential, introduced to avoid overdiagnosis and overtreatment of encapsulated follicular variants of papillary thyroid carcinoma (PTC). ¹,² We report a case of an adult male presenting with a solitary thyroid nodule clinically and radiologically suspicious for malignancy. Fine-needle aspiration cytology suggested atypia of undetermined significance – Bethesda category III, whereas USG neck was suggestive of TIRADS 5, prompting surgical intervention. Final histopathological examination revealed the diagnosis of NIFTP. This case highlights the diagnostic difficulty of NIFTP on preoperative fine-needle aspiration cytology and emphasizes the importance of strict histopathological criteria for accurate diagnosis and appropriate treatment.

Targeted RNA sequencing of thyroid tumors from individuals with PTEN hamartoma tumor syndrome reveals a unique transcriptome with a predominantly RAS-like expression profile.

Case No. 1: Oncocytic follicular neoplasm (category IV) according to the 2023 Bethesda system

Thyroid nodules are common in clinical practice, and fine-needle aspiration cytology (FNAC) remains the primary test for malignancy risk assessment. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) standardizes interpretation and guides management. This study evaluated the distribution of Bethesda categories, risk of neoplasia (RON) and malignancy (ROM), and the impact of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on risk stratification. A retrospective review of 2578 thyroid FNACs (2016-2024) was conducted at King George's Medical University, Lucknow. Cytological diagnoses were classified using TBSRTC (2017 and 2023). Histopathological correlation was available in 1043 cases (40.5%). RON and ROM were calculated for each category, with ROM assessed before and after excluding NIFTP. Smears were independently reviewed by two cytopathologists, and diagnostic metrics (sensitivity, specificity, accuracy) were derived using histopathology as reference; 95% confidence intervals were estimated by exact binomial methods. Most cases were Benign (73.2%), followed by Malignant (7.2%) and Follicular Neoplasm (6.1%). Malignancy was confirmed in 245 cases. ROM ranged from 3.7%-9.9% (Benign) to 58.6%-100% (Malignant), showing a progressive rise across categories. Reclassification of NIFTP notably reduced ROM for indeterminate categories (AUS: 43.2% → 31.8%; FN: 40.2% → 28.4%; SM: 52.4% → 42.9%). TBSRTC reliably stratifies malignancy risk in thyroid nodules. Reclassification of NIFTP has a substantial impact on ROM in indeterminate categories, underscoring the need for precise cytologic-histologic correlation and regional validation to optimize patient management.

Primary Thyroid Tuberculosis Masquerading as a Follicular Neoplasm With Tracheal Compression: A Case Report

BackgroundCytologically indeterminate thyroid nodules (CITNs) are heterogeneous, and their assessment remains controversial. In this study, we examined the prognostic utility of anti-thyroid antibodies for predicting thyroid cancer (TC) in CITNs.MethodsThis prospective multicenter analysis included all patients with CITNs who were surgically treated between August 2023 and August 2024 at two hospitals in Saudi Arabia; preoperative anti-thyroid antibodies [thyroid peroxidase and thyroglobulin antibodies (TgAbs)], thyroid stimulating hormone (TSH), and a definitive histological diagnosis were required for inclusion. Multivariate analysis was used to identify independent predictors of TC.ResultsThis study included 76 individuals; 70/76 (92.1%) were women. Overall, 43/76 (56.6%) nodules had a cytological diagnosis of atypia of undetermined significance (AUS) (Bethesda III), whereas 33/76 (43.4%) were follicular neoplasms (FNs) (Bethesda IV). Pathological analysis revealed that 56/76 (73.7%) patients had benign nodules and 20/76 (26.3%) had malignant tumors. The coexistence of elevated levels of both antibodies and TSH demonstrated the highest odds ratio [3.10; 95% confidence interval (CI): 1.14–5.47], signifying a significant correlation with TC (P=0.003). Furthermore, high levels of one antibody along with elevated TSH levels resulted in an odds ratio of 2.25 (95% CI: 1.02–6.44), indicating a significant association with TC (P=0.04). The multivariate analysis identified Bethesda IV cytological diagnoses, the presence of Hashimoto’s thyroiditis, and TSH levels >1 mIU/L as independent predictors of TC.ConclusionsElevated anti-thyroid antibody and TSH levels were effective predictors of TC in CITNs. These findings may help guide endocrine surgeons managing patients with these nodules.

Abstract: Background: Obesity and thyroid nodules have increased in frequency globally in recent years. Researchers are still exploring the complex relationship between obesity and cancer risk. Objective: To determine the association between obesity with differentiated thyroid cancer (DTC) in patients presenting with thyroid nodules. Materials and Methods: This cross-sectional study was performed in outpatient clinics of ENT department of Ruth K.M. Civil Pfau Hospital Karachi during 1st April, 2025 till 15th July, 2025. Thyroid ultrasound was performed by an experienced radiologist to confirm the presence of nodules, and patients meeting the criteria proceeded to cytological evaluation. The Bethesda classification was used to interpret Fine Needle Aspiration Cytology (FNAC) findings. Bethesda V and VI were interpreted as suspicious for malignancy and malignancy respectively. Result: The number of studied patients were 314. Mean age was 43.6 ± 11.4 years. 69.7% of people were overweight or obese. 22.9% of cases fell under Bethesda categories 5 or 6. On univariate analysis, risk of Bethesda 5/6 finding was significantly lower in patients who were having normal weight and overweight as compared to obese patients. On multivariable analysis, risk Bethesda 5/6 finding was lower in overweight patients than obese patients but there no significance of lower risk in patients with normal body mass index (BMI) levels than obese patients. Conclusion: While obesity was found to have a greater risk of differentiated thyroid cancer in univariate analysis, this was not consistently significant in all BMI categories in multivariable analysis. Therefore, the current study did not demonstrate a clear association of BMI and DTC cancer. Keywords: Body mass index, Obesity, Thyroid nodules, Differentiated thyroid cancer, Fine needle aspiration cytology, Follicular neoplasm.

The authors present surgical treatment of a patient with follicular thyroid tumor and parathyroid gland adenoma. Subsequent analysis recognized oncocytic thyroid gland adenoma manifested by clinical and laboratory picture of primary hyperparathyroidism. Multinodular goiter imitating parathyroid gland adenoma when one of the nodes is located behind thyroid lobe and intrathyroid location of parathyroid gland adenoma are factors complicating differential diagnosis. Therefore, this case of thyroid gland adenoma imitating functionally active parathyroid gland adenoma illustrates the need for alertness with respect to combination and mutual imitation of tumors of thyroid and parathyroid glands requiring surgical intervention. In addition, such cases require differential diagnosis between thyroid and parathyroid neoplasms based on all available laboratory and topical methods.

ObjectiveTo evaluate the clinical and oncological outcomes of transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) in the management of pediatric patients with benign and malignant thyroid lesions in Vietnam.MethodsA cross-sectional study was performed on pediatric patients (≤18 years old) who underwent TOETVA for thyroid cancer and benign thyroid nodules between August 2019 to September 2024.ResultsOf the 28 patients included in the study, 23 were female (82.1%), and 5 were male (17.9%) with a mean age of 15.86±2.45 years. Mean tumor size on ultrasound was 19.47±13.63 mm. TOETVA was completed successfully in all cases. Postoperative histopathological findings revealed benign lesions in 13 patients, differentiated thyroid carcinoma in 14 patients and non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in one patient; central neck dissection (CND) was performed in 15 patients; nine of them had occult lymph node metastasis. Postoperative complications included transient hypoparathyroidism (3.6%) and vocal cord palsy (7.1%), all of which resolved. No permanent complications or recurrences were observed over a median follow-up of 26.5 months.ConclusionsTOETVA appears feasible for the treatment of thyroid nodules in children. However, larger prospective studies are needed to confirm these findings.

Practical and challenging issue in thyroid cytopathology.

Feasibility and safety of transaxillary robotic thyroidectomy in Japan - Comparison with video-assisted neck surgery in initial cases.

ObjectiveThis retrospective study aimed to investigate the ultrasound characteristics of follicular thyroid adenoma (FTA) and follicular thyroid carcinoma (FTC) and to evaluate the diagnostic efficacy of Follicular Thyroid Imaging Reporting and Data System (F-TIRADS), American College of Radiology (ACR)-TIRADS, and Chinese (C)-TIRADS in differentiating FTC from FTA.Materials and methodsThis study included 399 patients with pathologically confirmed FTC or FTA who underwent preoperative thyroid ultrasonography. The ultrasound characteristics and the scores of F-TIRADS, ACR-TIRADS, and C-TIRADS were evaluated. Univariate analysis and multivariate logistic regression were conducted to identify independent predictors of FTC. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and p-values were compared.ResultsMultivariate logistic regression analysis identified unclear margins, spiculated margins, halo contour, uneven halo thickness, trabecular formation, and multifocal tumors as independent predictors of FTC (odds ratio [OR] = 4.74, 82.68, 0.07, 5.82, 3.26, and 82.09, respectively). The AUC values for the F-TIRADS, ACR-TIRADS, and C-TIRADS were 0.825 (95% confidence interval [CI]: 0.763–0.887), 0.713 (95% CI: 0.645–0.782), and 0.756 (95% CI: 0.685–0.827), respectively.ConclusionsUltrasound is valuable in differentiating FTC from FTA, with the F-TIRADS exhibiting superior diagnostic performance compared with those of the ACR-TIRADS and C-TIRADS.

Imaging-driven detection of thyroid nodules has expanded the role of fine-needle aspiration (FNA) while demanding integration of molecular data into routine cytologic assessment. We present four illustrative cases spanning the contemporary diagnostic spectrum: (1) an Atypia of Undetermined Significance (AUS) nodule with dual low-level PTEN mutations managed by active surveillance; (2) an oncocytic follicular neoplasm upgraded to total thyroidectomy by concurrent HRAS and TERT promoter mutations; (3) an oncocytic subtype poorly differentiated thyroid carcinoma (O-PDTC) highlighting subtle high-grade cytologic cues and a distinct genomic profile; and (4) a pediatric poorly differentiated carcinoma harboring a DICER1 hotspot mutation, underscoring age-specific biology and the need for genetic consideration. These cases emphasize that morphology remains foundational, but mutation context, single versus co-alterations, allelic burden, and patient age ultimately direct management. Harmonized reporting that clearly conveys molecular findings is essential to translate limited cytology material into precise, patient-specific care.

Thyroid nodules are relatively common, with a high incidence rate among adults, particularly women. With the widespread application of ultrasound imaging technology, the detection rate of thyroid nodules has significantly increased. However, traditional open surgery can lead to significant scar formation and potential thyroid dysfunction. Therefore, minimally invasive techniques that preserve thyroid function and aesthetic appearance are increasingly important. A 51-year-old Han Chinese female patient had nodules in both thyroid glands (right side C-TIRADS 4A, left side C-TIRADS 3). The patient was placed in a supine position with the neck extended ("human" position). Following ultrasound guidance, a localization needle was precisely marked at the nodule in the left lower pole, with the needle tip positioned at the deep margin of the lesion. The needle tail was secured to the skin with sterile tape. Trocar incisions were made at the margins of both areolas and the right upper outer quadrant. Carbon dioxide was insufflated to 6mmHg to create the surgical space. The right thyroid lobe and isthmus were completely resected; subsequently, the surgeon shifted to the left thyroid lobe, identified the preplaced localization needle via endoscopy, and traced it to the nodule at the left lower pole. A circular dissection was performed around the needle tip with a 0.5-cm margin of normal tissue, precisely resecting the nodule. The localization needle enabled real-time, targeted resection under intraoperative guidance. Combining ultrasound-guided localization needles with endoscopic thyroidectomy via the trans-breast approach offers a minimally invasive surgical option that preserves thyroid function and aesthetics while enabling precise resection of thyroid nodules, minimizing damage to normal tissue, and improving patient outcomes. This surgical method holds great potential in the field of thyroid surgery, achieving a balance between radical resection and functional preservation. Highlights 1. Precision-guided minimally invasive surgery: this study introduces an innovative integration of ultrasound-guided needle localization with endoscopic thyroidectomy via the areola approach, achieving highly precise resection of thyroid nodules. The method significantly improves surgical accuracy, especially for small or nonpalpable nodules located deep within the thyroid gland. 2. Function-preserving surgical strategy: by restricting the resection margin to only 0.5cm beyond the lesion, the technique maximizes preservation of normal thyroid tissue. Consequently, the patient maintained relatively stable postoperative thyroid function, requiring only minimal hormone replacement therapy. 3. Excellent cosmetic and clinical outcomes: the areola-based access route provided a scar-free aesthetic result, while the patient recovered smoothly without complications such as hoarseness or hypocalcemia. The procedure was completed in a reasonable duration with minimal blood loss, underscoring both the safety and efficiency of the approach. 4. Pathological and functional validation: postoperative pathology confirmed complete resection of a papillary thyroid carcinoma in the right lobe and a noninvasive follicular thyroid neoplasm in the left lobe. No residual disease was detected, and subsequent thyroid function tests validated the success of the tissue-preserving strategy. This case highlights a promising advancement in thyroid surgery by merging technological precision with functional and cosmetic priorities. It underscores the potential for broader clinical adoption of approaches that balance oncologic safety with quality-of-life outcomes.

We report the first well-documented case of in situ follicular B-cell neoplasm (ISFN) arising in splenosis in a patient with a remote history of splenectomy. A 60-year-old man undergoing evaluation for hydrocele was incidentally found to have multiple mesenteric masses on imaging. His past surgical history was notable for splenectomy 40years earlier following a motor vehicle accident. Biopsy of the largest mass revealed fragments of splenic parenchyma containing two small follicles infiltrated by atypical lymphocytes. Follicular architecture was preserved without expansion or disruption. Immunohistochemistry demonstrated that the neoplastic cells were positive for CD20, PAX5, CD10, BCL2, and BCL6 and negative for CD3 and CD5. Flow cytometry performed on a concurrent specimen identified a clonal CD10-positive aberrant B-cell population. Fluorescence in situ hybridization (FISH) revealed a chromosomal translocation, t(14;18). These findings supported a diagnosis of ISFN.

Thyroid lesions are a common finding, especially in the adult population, based on the evidence that more than 50% of individuals have thyroid nodules. The increasing detection of these lesions is mostly due to frequent ultrasonographic head and neck evaluation, which can now identify small subcentimeter nodules. Fortunately, most of these nodules are benign (70%), with only 5-10% of them attributed as malignant lesions. However, the remaining 20% falling into the category of indeterminate lesions which can lead to some pitfalls and tricky evaluations. Since 1996, different classification systems have been introduced and among them, the most worldwide adopted is the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). It is well-known that TBSRTC as well as other classification systems, subclassified indeterminate lesions into subgroups which specifically for the TBSRTC include a) atypia of undetermined significance (AUS), b) follicular or oncocytic cell neoplasm (FN) and c) suspicious for malignancy (SFM). However, despite the high positive predictive value (97%-99%), sensitivity (65%-99%) and specificity (72%-100%) of thyroid FNAC, diagnostic pitfalls exist that can lead to false positive and/or false negative results. This inconvenience is mostly due to the overlapping of morphological features in terms of cells and even background. This review discusses the most important potential pitfalls in the cytologic evaluation of thyroid lesions that can lead to such diagnostic errors.

Objective: To assess thyroid lesions and biochemical alterations in untreated hyperthyroid patients. Study Design: Hospital based observational cross-sectional study Place and Duration of Study: This study was conducted at the MINAR Cancer Hospital, Multan from January 2023 to December 2024. Methods: A total of 1,000 thyroid disorder patients were enrolled at MINAR Cancer Hospital, South Punjab, Pakistan. Clinical evaluation and thyroid function tests (TFTs) identified 272 hyperthyroid patients, 325 euthyroidcontrols, and 403 with other thyroid disorders. FNAC was performed in 403 cases and categorized using the Bethesda system. Thyroid scans showed predominantly low radioiodine uptake, enabling stratification into hyperthyroid and FNAC groups. Hematological indices, including WBC, RBC parameters, platelet count, and MPV, were assessed. Statistical analyses employed One-way ANOVA, Student’s t-test, Chi-square, Pearson, andSpearman correlations, with p<0.05 considered significant. Results: FNAC analysis showed 35.60% of patients with colloid nodule (Bethesda II), 18.18% with follicular neoplasm (Bethesda IV), 23.07% suspicious for malignancy (Bethesda V), and 18.8% malignant (Bethesda VI). Malignancy was more frequent in patients above 45 years, while residence near the hospital had no effect on malignancy distribution. Hematological findings in untreated hyperthyroid patients revealed significant changes in RBC (p=0.004), MPV (p=0.000), and platelet count (p=0.000). Correlation analysis demonstrated negative associations of T4 with HGB, HCT, MCV, and MCH, and a positive association of MPV with T4 across different subgroups. Conclusion: FNAC classifies thyroid lesions cytologically, while hematological and biochemical parameters reveal systemic changes, aiding diagnosis and treatment planning independently.

IntroductionTrophoblast cell surface antigen-2 (TROP-2), a transmembrane glycoprotein associated with trophoblast cells, is found to have a potential role in the proliferation of cancer cells and their ability to progress, invade and survive. An immunohistochemical study of TROP-2 can be helpful to differentiate benign and malignant thyroid lesions and guide clinical management. The study aimed to evaluate the diagnostic significance of TROP-2 expression in thyroid lesions.Materials and methodsThis cross-sectional study was conducted in a tertiary care teaching hospital, which included 44 cases of benign and malignant thyroid lesions. Tissue sections (4 µm thick) were obtained from paraffin-embedded blocks after deparaffinization and antigen retrieval in citrate buffer. The samples were tested for TROP-2 expression by immunohistochemistry. Collected data were entered in Microsoft Excel (Microsoft Corporation, Redmond, WA), and statistical analysis was performed using Statistical Packages for Social Sciences (SPSS) Version 23.0 (IBM Corp., Armonk, NY). A p-value less than 0.05 was considered statistically significant.ResultsThe mean age of the study population was 42.84, and the range was from 16 years to 75 years. Among them, 37 subjects (84.09%) were female. On histopathological examination, 17 cases (38.64%) were diagnosed as benign thyroid lesions, 26 cases (59.09%) were of malignant thyroid lesions, and one case was diagnosed as a borderline lesion (non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)).The proportion of TROP-2 positivity was significantly different between benign and malignant thyroid lesions, and between papillary thyroid carcinoma (PTC) and non-PTC malignant lesions. The sensitivity of TROP-2 IHC testing was found to be 69.23% for diagnosing malignant thyroid lesions and 78.26% for diagnosing PTC cases. The specificity and positive predictive value in both conditions were observed to be 100%. The proportion of TROP-2 positivity did not significantly differ among the different tumour stages and lymph node status groups.ConclusionTROP-2 as a diagnostic marker was observed to have high specificity, which indicates that it has a promising role as an adjunct diagnostic method to the currently available methods. However, TROP-2's sensitivity is found to be moderate, which indicates that this marker cannot be used as a standalone diagnostic tool but rather in conjunction with other markers and histopathological examination.