The Diagnosis and Management of Thyroid Nodules

Abstract

Most thyroid nodules are benign. A diagnostic approach that uses ultrasound and, when indicated, fine-needle aspiration biopsy and molecular testing, facilitates a personalized, risk-based protocol that promotes high-quality care and minimizes cost and unnecessary testing.

Differentiated thyroid cancer in childhood: a literature update

“…40 There is no benefit of RAI remnant ablation in pediatric patients with intrathyroidal disease and no lymph node disease. 58 The postoperative activity of I 131 administration is usually 37-74 MBq/kg (1-2 mCi/kg). An alternative to the fixed doses is a pretherapeutic dosimetry; I 131 activities that are as high as safely administrable (AHASA) are at least 200 MBq/kg but in those patients with extensive pulmonary metastases a complete dosimetry including lung dose estimate is the only method to assess safe I 131 activity.…”

Clinical validation of the ThyroSeq v3 genomic classifier in thyroid nodules with indeterminate FNA cytology

“…An accurate distinction between benign and cancerous thyroid nodules is important to offer the most appropriate treatment to patients. Since its introduction in the United States in the 1980s, fine‐needle aspiration (FNA) biopsy, which currently is performed in the majority of cases with ultrasound guidance, represents the most effective triage procedure to reliably distinguish benign from malignant thyroid nodules in approximately 60% to 80% of cases, whereas the remaining nodules are diagnosed as “indeterminate for malignancy” on FNA, mainly due to the lack of specific cytomorphologic features needed for a definitive diagnosis…”

“…[4][5][6] An accurate distinction between benign and cancerous thyroid nodules is important to offer the most appropriate treatment to patients. Since its introduction in the United States in the 1980s, fine-needle aspiration (FNA) biopsy, which currently is performed in the majority of cases with ultrasound guidance, represents the most effective triage procedure to reliably distinguish benign from malignant thyroid nodules in approximately 60% to 80% of cases, 7,8 whereas the remaining nodules are diagnosed as "indeterminate for malignancy" on FNA, mainly due to the lack of specific cytomorphologic features needed for a definitive diagnosis. 9 In the updated version of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), the indeterminate cytologic diagnoses based on cytologic features are categorized as either atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) (TBSRTC category III), follicular or oncocytic (Hurthle cell) neoplasm/suspicious for a follicular or oncocytic (Hurthle cell) neoplasm (FN/SFN) (TBSRTC category IV), or suspicious for malignancy (TBSRTC category V).…”

Surgical impact of a dedicated endocrine surgeon on an academic otolaryngology department

“…Progress in our understanding of thyroid and parathyroid pathophysiology and molecular biology, as well as advancements in diagnostic procedures, imaging, and surgical treatment techniques, have all contributed considerably to the maturation of the field. [1][2][3] Concurrently, the number of endocrine surgeries being performed in the United States has seen steady growth. 4 In parallel with the increased need for endocrine operations, the background training of the surgeons performing these operations has changed.…”