NIFTP diagnostic and therapeutic approach

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Published Feb 1, 2025
https://doi.org/10.62438/tunismed.v103i2.4918
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Vol. 103 No. 2 (2025): Tunis Med Feb 2025

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Nadia Romdhane
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Dorra Chiboub
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Amira Khaldi
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Jihene Gharsalli
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Imen Zoghlami
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Safa Nefzaoui
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Ines Hariga
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Chiraz Mbarek
ENT and Head and Neck Surgery Department, Habib Thamer Hospital, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia

Abstract

Background: Non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) still spark controversy regarding histological diagnostic criteria and therapeutic management.


Aim: To elucidate the clinicopathological characteristics of NIFTP tumors and discuss their therapeutic management.


Methods: A retrospective study including 23 patients (26 nodules) operated on and followed up for NIFTP tumors according to the 2017 WHO classification over a 5-year period (January 2016-December 2020). The 2017 EUTIRADS classification was used for ultrasound nodule characterization. Fine-needle aspiration cytology was reported according to the 2017 Bethesda system.


Results: All patients were female, with a mean age of 47 years [19-71]. The average consultation delay was 9 months [2 months–7 years]. Thyroid nodules were incidentally discovered in 6 cases (26%). Examination revealed a solitary thyroid nodule in 20 cases. Nodules were classified as EUTIRADS III or IV in 82%. Fine-needle aspiration cytology, performed in 61% of cases, showed Bethesda III in 64% and IV in 14%. Total thyroidectomy was performed in 74%. Three cases of bifocal NIFTP were identified. Association with thyroid carcinoma was noted in 7 cases. No locoregional or distant recurrence was reported during a mean follow-up of 3 and a half years.


Conclusion: Recent revisions of NIFTP morphological criteria underscore the importance of strict adherence to inclusion and exclusion histo-morphological criteria.

Keywords:

Thyroid tumor, NIFTP, ultrasound, fine needle aspiration, surgery

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