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Background/Aim. Establishing a preoperative diagnosis of thyroid follicular tumors is difficult due to the fact that the cell morphology of adenomas and carcinomas are similar and that capsular and vascular invasion cannot be determined by cytology. We analyzed predictive factors of follicular carcinoma in order to enable a surgeon to indicate operative treatment and to perform an adequate operation for each patient with a follicular neoplasm. Methods. In this retrospective study, we analyzed medical records of all patients with follicular thyroid tumors operated at an endocrine surgery unit of a tertiary referral academic hospital, between 2008 and 2012. A total of 263 operated patients were included and divided into follicular adenomas (n = 97) and follicular carcinomas (n = 166) based on the histopathology results. The most important demographic and clinical characteristics were analyzed by univariate and multivariate logistic regression analysis. Results. In adenoma group (19 males, 78 females) age range was 19–79, mean age 50. In carcinoma group (35 males, 131 females) age range was 15– 78, mean age 48. Univariate analysis showed that thyroglobulin concentration ≥ 500 ng/mL, tumor diameter < 30 mm, presence of more than one thyroid nodule and an afunctional/hypofunctional nodule were significantly more frequent in follicular carcinoma than in follicular adenoma. Independent predictive factors of malignancy were: elevated preoperative thyroglobulin concentration (≥ 500 ng/mL) and presence of more than one nodule. Based on our results we formed a nomogram, a two-dimensional diagram designed to enable estimation of preoperative probability of malignancy. Conclusion. Elevated preoperative thyroglobulin concentration, ≥ 500 ng/mL, and the presence of more than one nodule are independent predictors of malignancy for follicular thyroid carcinomas.

Introduction/Objective. Adrenocortical carcinomas (ACCs) are very rare tumors with grave prognosis despite multimodal treatment. The aim of our study was to determine the incidence and mortality of ACCs in Central Serbia. Methods. The study period was from 1999 to 2012. We used data from the Cancer Registry of Central Serbia. Incidence and mortality rates were sex- and age-standardized according to Segi’s world population. Results. In the defined period of the study, 128 patients with a diagnosis of ACC were registered and the female-to-male ratio was 1.3:1. The median age of affected individuals was 42.3 years. There were two main age peaks – one in childhood (0–9 years), and the other in the fifth and sixth decade of life. In this period, the average standardized incidence rate of ACC amounted to two per million people with slightly increasing trend. The largest number of male patients with ACC (22; 39.2%) was registered in the age group of 0–9 years, while the largest number of patients in females was shown to be in the age group of 40–49 years (29; 40.3%). During the study period, there were 35 deaths registered in patients with ACC (mean age of 61.2 years). The average mortality rate of ACC was 0.3 per million people. The male-to-female ratio was 1.5:1. Most fatal outcomes were registered in the age groups of 50–59 and 60–69 years, so 91.4% of all deaths took place in the age groups 50+. Conclusion. ACC is an extremely rare tumor that occurs more often in women than in men. However, fatal outcomes occur more frequently in males. [Project of the Ministry of Education, Science and Technological Development of the Republic of Serbia, Grant no. 175042]

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