Thyroid Nodules 2006: Managing what has been known for over 50 years

Garber, Jeffrey R.

doi:10.14310/horm.2002.11188

Cited by 9 publications

(6 citation statements)

References 49 publications

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“…While approximately 95% of thyroid nodules are benign, certain historical, laboratory, and sonographic features raise the suspicion for malignancy [5]. As the initial step for evaluation of a thyroid nodule is measurement of serum thyroid stimulating hormone (TSH) [6,7], it is not uncommon for patients with a solitary thyroid nodule to be diagnosed with hyperthyroidism. In this setting, the thyroid nodule may represent a solitary hyperfunctioning thyroid nodule in an otherwise normal thyroid gland or it may represent a hyperfunctioning or nonfunctioning nodule occurring within a toxic multinodular goiter, within a Graves’ disease or destructive thyroiditis milieu, or in an individual with a less common cause of thyrotoxicosis [8].…”

Section: Introductionmentioning

confidence: 99%

A solitary hyperfunctioning thyroid nodule harboring thyroid carcinoma: review of the literature

et al. 2013

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Hyperfunctioning nodules of the thyroid are thought to only rarely harbor thyroid cancer, and thus are infrequently biopsied. Here, we present the case of a patient with a hyperfunctioning thyroid nodule harboring thyroid carcinoma and, using MEDLINE literature searches, set out to determine the prevalence of and characteristics of malignant “hot” nodules as a group. Historical, biochemical and radiologic characteristics of the case subjects and their nodules were compared to those in cases of benign hyperfunctioning nodules. A literature review of surgical patients with solitary hyperfunctioning thyroid nodules managed by thyroid resection revealed an estimated 3.1% prevalence of malignancy. A separate literature search uncovered 76 cases of reported malignant hot thyroid nodules, besides the present case. Of these, 78% were female and mean age at time of diagnosis was 47 years. Mean nodule size was 4.13 ± 1.68 cm. Laboratory assessment revealed T3 elevation in 76.5%, T4 elevation in 51.9%, and subclinical hyperthyroidism in 13% of patients. Histological diagnosis was papillary thyroid carcinoma (PTC) in 57.1%, follicular thyroid carcinoma (FTC) in 36.4%, and Hurthle cell carcinoma in 7.8% of patients. Thus, hot thyroid nodules harbor a low but non-trivial rate of malignancy. Compared to individuals with benign hyperfunctioning thyroid nodules, those with malignant hyperfunctioning nodules are younger and more predominantly female. Also, FTC and Hurthle cell carcinoma are found more frequently in hot nodules than in general. We were unable to find any specific characteristics that could be used to distinguish between malignant and benign hot nodules.

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Section: Introductionmentioning

confidence: 99%

A solitary hyperfunctioning thyroid nodule harboring thyroid carcinoma: review of the literature

et al. 2013

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“…The majority of patients with benign or malignant thyroid nodules are euthyroid. Despite this, serum TSH measurement is recommended in all patients presenting with nodule [4,13,15,16].…”

Section: Thyroid Stimulating Hormone (Tsh)-antithyroid Antibodiesmentioning

confidence: 99%

“…Medullary thyroid carcinoma (MTC) makes up only 5% of thyroid malignancies; however, recent reports have concluded that prevalence of MTC ranges from 0.4 to 1.4% in unselected patients with noduler thyroid disease. The routine calcitonin (CT) measurement to improve the preoperative diagnosis of MTC in nodular thyroid disease remains controversial [16,19].…”

Section: Calcitoninmentioning

confidence: 99%

The Evaluation of Thyroid Nodules

nar¹

2014

Thyroid Disorders Ther

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Thyroid noduler disease is a common clinical problem. A wide variety of pathologic conditions, including neoplastic, hyperplastic, and inflammatory diseases can lead to nodular enlargement of the thyroid. The high prevalence of thyroid nodules requires evidence-based rational strategies for their differential diagnosis, risk satisfaction, treatment, and follow-up. The main point of the approach of the thyroid nodule is detection of the malignant nodules and deciding for the surgical treatment. Physical examination, laboratory investigation, thyroid imaging and cytology can be used to evaluate thyroid nodules. After detection of thyroid nodule by physical examination or ultrasonography, thyroid function tests and fine needle aspiration (FNA) biopsy should be implemented. Although FNA cytology is gold standard method to evaluate thyroid nodules, experience is needed. Hence, if the information gathered from history, physical examination, US and other test results (Thyroid function tests, SC, CT, etc.) were integrated withFNA cytology, decision for surgery may be more accurate.

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“…Bij het papillaire schildkliercarcinoom is de survival beter wanneer er een totale thyreoïdectomie plaatsvindt, maar bij het folliculaire carcinoom is een hemithyreoïdectomie afdoende. 22,23 De prognose van het gedifferentieerde schildkliercarcinoom is relatief gunstig met een mortaliteit van 1% na tien jaar. 5,24 In onze kliniek werd laagdrempelig besloten de schildkliernodus te verwijderen door middel van een hemiof totale thyreoïdectomie.…”

Section: Dunnenaaldbiopsieunclassified