Background and objective Artificial intelligence (AI) applications such as Chat Generative Pre-Trained Transformer (ChatGPT) created by OpenAI, which represent the revolutionary aspects of today's technology, have benefitted professionals in many fields and society at large. In this study, we aimed to assess how effective is ChatGPT in helping both the patient and the physician manage thyroid nodules, a very common pathology. Methods Fifty-five questions frequently asked by patients were identified and asked to ChatGPT. Subsequently, three cases of thyroid nodules were progressively presented to ChatGPT. The answers to patient questions were scored for correctness and reliability by two endocrinologists. As for the cases, diagnostic and therapeutic approaches provided by ChatGPT were analyzed and scored by two endocrinologists for correctness, safety, and usability. The responses were evaluated by using 7-point Likert-type scales designed by us. Results The answers to patient questions were found to be mostly correct and reliable by both raters (Rater #1: 6.47 ± 0.50 and 6.27 ± 0.52; Rater #2: 6.18 ± 0.92 and 6.09 ± 0.96). Regarding the management of cases, ChatGPT's approach was found to be largely correct, safe, and usable by Rater #1, while Rater #2 evaluated the approaches as partially or mostly correct, safe, and usable. Conclusion Based on our findings, ChatGPT can be used as an informative and reliable resource for managing patients with thyroid nodules. While it is not suitable to be used as a primary resource for physicians, it has the potential to be a helpful and supportive tool.

Accurate tumor localization is necessary for the application of minimally invasive surgery, which is preferred in the treatment of primary hyperparathyroidism. Parathormone-washout (PTH-WO) is parathyroid fine-needle aspiration followed by PTH measurement in the needle washout fluid. This study aimed to determine appropriate cutoff values for the PTH-WO method. A total of 402 PTH-WO assays from 339 patients were included in the study. The diagnostic accuracy of the test was assessed by accepting as a positive result a PTH-WO result higher than the serum PTH level [PTH-WO/serum PTH(PTH ratio)>1]. In addition, a cutoff value for the test was established by evaluating the PTH washout results obtained in comparison with postoperative histopathology. Undiluted test results were not included to obtain a clear numerical value in this evaluation. The results of parathyroid scintigraphy and fine needle aspiration biopsy (FNAB) were compared with postoperative histopathology. While 309 (76.86%) of the PTH-WO procedures were considered positive, 93 (23.13%) were considered negative if the PTH ratio was > 1. When these results were compared with the postoperative histopathology, the test's sensitivity was 92.51%, and the specificity was 100.00%. In the analysis of the remaining 292 PTH-WO samples after excluding the undiluted ones, the sensitivity and specificity of the method were 92.3% and 94.1%, respectively, with a PTH ratio > 0.99. With a cutoff value of 99.5 ng/l for PTH-WO value, 93.1% sensitivity and 94.3% specificity were obtained. The sensitivities of parathyroid scintigraphy and FNAB were 53.4% and 15.3%, respectively. The PTH-WO method is safe and cheap, with high sensitivity and specificity in localizing parathyroid tumor. In cases where radiological methods cannot achieve localization with specified cutoff values, it has high diagnostic accuracy.

SUMMARY Malignant mesenchymal thyroid tumors are one of the rarest types of thyroid cancer. Clinically, these tumors present as a rapidly growing thyroid mass. Due to their rarity and nonspecific findings, they are not the first conditions that come to mind during differential diagnosis. We report herein the case of an 87-year-old woman presenting with a rapidly growing thyroid mass in whom the differential diagnosis of anaplastic cancer was challenging. Following work up, the patient was diagnosed with primary fibrosarcoma [...] SUMMARY Malignant mesenchymal thyroid tumors are one of the rarest types of thyroid cancer. Clinically, these tumors present as a rapidly growing thyroid mass. Due to their rarity and nonspecific findings, they are not the first conditions that come to mind during differential diagnosis. We report herein the case of an 87-year-old woman presenting with a rapidly growing thyroid mass in whom the differential diagnosis of anaplastic cancer was challenging. Following work up, the patient was diagnosed with primary fibrosarcoma