Dr. Milas responded that total thyroidectomy would be advised based on abnormal TSHR mRNA levels because a positive predictive value of 96% is reassuring and has held up in daily practice since the analysis was closed.
She said the assay is not accurate enough, however, to recommend observation in sonographically suspicious, 2.5-cm or greater tumors with undetectable TSHR mRNA levels, but “is possibly and cautiously” enough when combined with an informed discussion with the patient when smaller lesions lack concerning ultrasound features and in patients with medical comorbidities who face increased risk during a diagnostic thyroidectomy.
Disclosures: Dr. Milas and Dr. Weber stated they had no relevant disclosures.
TSHR mRNA had a positive predictive value of 100% in patients with papillary thyroid cancers greater than 1 cm.
Source DR. MILAS