{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:53:48Z","timestamp":1785434028490,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011892","name":"Chang Gung Memorial Hospital-Kaohsiung Medical Center","doi-asserted-by":"publisher","award":["CMRPG8Q0871"],"award-info":[{"award-number":["CMRPG8Q0871"]}],"id":[{"id":"10.13039\/501100011892","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Science and Technology Council","award":["NSTC 113-2314-B-182A-138 -MY2"],"award-info":[{"award-number":["NSTC 113-2314-B-182A-138 -MY2"]}]},{"award":["NSTC 113-2314-B-182A-138 -MY2"],"award-info":[{"award-number":["NSTC 113-2314-B-182A-138 -MY2"]}],"id":[{"id":"https:\/\/ror.org\/02kv4zf79","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hyperfunctioning thyroid nodules are generally considered to have a low malignancy risk, but data on genuine hyperfunctioning thyroid neoplasms remain limited. This study aimed to characterize the clinicopathologic features and diagnostic implications of true hyperfunctioning thyroid neoplasms through lesion-level imaging-pathologic correlation and to estimate their observed frequency within a surgically treated cohort. Methods: We retrospectively reviewed 82 hyperthyroid patients at our institution with thyroid scintigraphy suggestive of solitary or multiple toxic nodules between 2014 and 2024; 25 underwent thyroidectomy. True hyperfunctioning thyroid neoplasms were defined by lesion-level imaging-pathologic correlation. Results: Among the 25 surgically treated patients, seven had confirmed hyperfunctioning carcinoma or tumors of uncertain malignant potential (UMP) (28.0%; 95% CI, 14.1\u201347.8%). When referenced against the full scintigraphic cohort of 82 patients, of whom only 30.5% underwent surgery, the observed rate was 8.5% (95% CI, 4.2\u201316.6%); however, this figure should be interpreted with caution given the inherent surgical selection bias. Four patients had overt carcinomas. The remaining three patients had UMPs. In nodule-based analysis, hyperfunctioning neoplasms were significantly larger than coexisting tumors (5.0 \u00b1 2.8 vs. 0.8 \u00b1 0.7 cm, p = 0.007) and more often follicular-patterned (85.7% vs. 27.3%; RR, 3.14; 95% CI, 1.14 to 8.64; p = 0.0498). Conclusions: These findings indicate that hyperfunctioning status does not definitively exclude malignancy, while also emphasizing that the absolute malignancy frequency in unselected hyperthyroid populations remains uncertain.<\/jats:p>","DOI":"10.3390\/diagnostics16142249","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:32:08Z","timestamp":1784514728000},"page":"2249","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Malignancy Risk Within Hyperfunctioning Thyroid Nodules: Clinicopathologic Features and Diagnostic Implications"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1294-4972","authenticated-orcid":false,"given":"Pang-Jui","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-Yu","family":"Chi","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-8070","authenticated-orcid":false,"given":"Shun-Chen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4491-0076","authenticated-orcid":false,"given":"Yen-Hsiang","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3972-2225","authenticated-orcid":false,"given":"Chen-Kai","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"},{"name":"College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/EP161208.GL","article-title":"American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules\u20142016 Update Appendix","volume":"22","author":"Gharib","year":"2016","journal-title":"Endocr. 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Imaging"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/14\/2249\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:12:02Z","timestamp":1784520722000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/14\/2249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":24,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["diagnostics16142249"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16142249","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]}}}