Introduction: Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a recently recognized entity introduced in the 2017 WHO classification because of its indolent behavior and excellent prognosis. Data from Madagascar remain limited. This study aimed to describe the epidemiological and histopathological features of NIFTP in the study setting.

Materials and Methods: A retrospective descriptive study was conducted at the Department of Pathology of the University Hospital Center Joseph Ravoahangy Andrianavalona (CHU-JRA) over a 5-year period, from January 2020 to December 2024.

Results: During the study period, 20 cases of NIFTP were identified, accounting for 6% of thyroid lesions and 27.7% of papillary thyroid carcinomas. The mean age of patients was 38 ± 12 years, ranging from 16 to 69 years. A marked female predominance was observed, with a sex ratio of 0.18. Total thyroidectomy was performed in 60% of cases. Macroscopically, in 55% of cases, the lesion presented as a single, well-encapsulated nodule measuring 0.2 to 10 cm. Histologically, the tumors showed a microfollicular or macrofollicular architecture associated with papillary-type nuclear atypia, without significant papillary architecture or capsular and vascular invasion.

Conclusion: NIFTP is a thyroid entity with low malignant potential and an excellent prognosis. Its diagnosis relies on strict histopathological criteria, allowing conservative management and reducing overtreatment of patients.