A patient underwent fine needle aspiration cytology for multinodular goiter. The repo was suspicious for papillary thyroid carcinoma. What is the percentage of risk malignancy in this patient?

For multinodular goiters, the four largest nodules (>/= 1 cm diameter) should be biopsied to minimize the risk of missing a malignancy. When FNA cytology is "suspicious" for papillary thyroid carcinoma or Huhle cell neoplasm, the risk of malignancy is 57%. When FNA cytology is a "suspicious" for follicular carcinoma, the overall risk of malignancy is about 20-25%, and higher for patients who are much younger or older than age 50. Most patients with suspicious FNA cytology are advised to have surgery. Ref: Fitzgerald P.A. (2013). Chapter 26. Endocrine Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow, T.G. Berger (Eds), CURRENT Medical Diagnosis & Treatment 2014.