Objective: We aimed to detect if there were any radiologic, demographic, or clinical findings that were valuable for differentiating benign nodules from malignant nodules in old aged patients, when the results of the first fine-needle aspiration biopsy (FNAB) were reported as atypia of undetermined significance (AUS).
Materials and Methods: Patients aged 65 years and older who were biopsied from thyroid nodules were analyzed retrospectively in this study. A total of 1264 patients with 1374 nodules were enrolled and of these, 203 patients with 216 nodules were recorded to have diagnosis of AUS in pathological evaluation. We excluded 104 nodules on which FNAB had been performed only once and included 112 nodules, on which FNAB had been performed twice. Out of these included patients, a total of 43 patients were thyroidectomized. Preoperative ultrasonographic nodular findings, echogenicity, marginal [ir]regularity, calcification, exophytic configuration, and halo were recorded.
Results: The median patient age was 69 years. There was no statistically significant difference between the results of the first and second FNABs. Hypoechogenicity was the only statistically significant different characteristic found in thyroid nodules that could effectively discriminate between malignant and benign groups.
Conclusion: The second FNAB does not increase the likelihood of diagnosing malignancy in old aged patients and there is no need for this procedure when recommending surgery. Suspicious USG findings are more frequent among malignant nodules, as reported in the histopathological evaluation of the old aged patients. A multidisciplinary team should take part in the decision-making process for the treatment of old aged patients after the first FNAB, with due consideration of the history, physical examination, USG, FNAB laboratory findings, and patient preference.