Year: 2026
Type: article
Study design: Observational Study
Abstract: Thyroid nodules are common, and although nodule size remains an important consideration in clinical decision-making, its relationship with malignancy remains controversial. Surgical studies have reported conflicting findings, and data from Libya and North Africa remain limited. To examine the association between maximum preoperative ultrasound-measured nodule size and final histopathological diagnosis in a Libyan surgical cohort. A prospectively maintained thyroid registry from Alrazi University Teaching Hospitals, Misurata, Libya (2022–2025), was retrospectively reviewed. Duplicate records were removed, and patients with definitive surgical histopathological diagnoses were included. Analyses involving nodule size were restricted to cases with available preoperative ultrasound measurements. NIFTP was analysed separately. Cases with benign and malignant histopathological diagnoses were compared using the Mann–Whitney U test, Fisher's exact test, and univariable logistic regression. Among 78 patients, 54 lesions were benign, four were NIFTP, and 20 were malignant. Maximum ultrasound-measured nodule size was available for 56 lesions, of which 52 benign or malignant lesions were included in the primary analysis. Cases with malignant histopathological diagnoses had a smaller median recorded maximum ultrasound nodule size than cases with benign histopathological diagnoses (12 vs 30 mm; P = 0.013). Cases with a recorded maximum nodule size <20 mm had higher observed odds of malignant histopathology than cases with a recorded maximum nodule size ≥20 mm (OR 10.40, 95% CI 2.78–38.89; P = 0.00034). However, nodule size analysed as a continuous variable was not significantly associated with malignancy (OR per 10-mm increase 0.74, 95% CI 0.53–1.04; P = 0.086). In this surgically treated Libyan cohort, cases with a recorded maximum nodule size <20 mm showed higher observed odds of malignant histopathology, whereas nodule size was not significantly associated with malignancy when analysed as a continuous variable. Nodule size should complement, rather than replace, ultrasound risk features and cytological assessment when evaluating thyroid nodules.
Source: Razi Medical Journal
DOI: 10.69667/rmj.26317
Authors: Wafaa Babh, Mohamed Elfagieh
Institution: Misurata University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7203568075