Risk of Malignancy in Thyroid Nodules 4 cm or Larger

Megwalu, Uchechukwu C.

doi:10.3803/enm.2017.32.1.77

Cited by 28 publications

(31 citation statements)

References 25 publications

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“…In another study, McHenry et al have reported that the mean diameter of malignant nodules is lower than that of benign nodules (p< 0.001), and therefore, the nodule diameter could not be a predictor of malignancy (10). (20). In our study, there was no significant difference between the > 4 cm group and the < 4 cm group in terms of malignancy (p= 0.91).…”

Section: Discussioncontrasting

confidence: 66%

“…They have recommended not to use nodule size as a single independent factor while making the decision on thyroidectomy for ≥ 4 cm nodules (15). Megwalu et al have found false negativity rate of FNAB as 0% in their study with ≥ 4 cm nodules, and they have recommended not to perform thyroidectomy automatically in every patient with ≥ 4 cm nodule and a benign FNAB result (20). Kuru et al have found that false negative rates are 1.3% and 4.3% when they have compared < 4 cm nodules and ≥ 4 cm nodules, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Malignancy risk for thyroid nodules larger than 4 cm and diagnostic reliability of ultrasound-guided FNAB results

Karadeniz

Yur²,

Temiz

et al. 2019

Turk J Surg

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Malignancy risk for thyroid nodules larger than 4 cm and diagnostic reliability of ultrasound-guided FNAB results

Karadeniz

Yur²,

Temiz

et al. 2019

Turk J Surg

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“…The authors stated that large nodule size should not be considered as an indication for diagnostic surgery. However, Raj et al and Megwalu et al reported that the malignancy rate was not associated with the risk of malignancy in ≥40 mm nodules . Consistent with Albuja‐Cruz et al, nodule size did not affect the reliability of FNAC and lobectomy was not recommended for diagnostic purposes when evaluating large nodules.…”

Section: Discussionmentioning

confidence: 71%

The influence of thyroid nodule size on the diagnostic efficacy and accuracy of ultrasound guided fine‐needle aspiration cytology

Aydoğan

Şahi̇n

Ceyhan

et al. 2019

Diagnostic Cytopathology

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Background Diagnostic accuracy of fine‐needle aspiration cytology (FNAC) in large and subcentimeter nodules is still debated. We aimed to evaluate the impact of nodule size on efficacy of the ultrasound‐guided FNAC. Methods B‐mode grayscale ultrasound (US), US‐guided FNAC according to Bethesda system and histopathological data of 514 nodules from 371 patients, who underwent thyroidectomy were examined retrospectively. Nodules were grouped by maximal diameter; group A nodules were smaller than 10 mm (n = 59), group B nodules were between 10 and 29 mm (n = 218), and group C nodules were 30 mm or greater (n = 130). Results Sensitivity, specificity, and accuracy of FNAC was 92.0%, 100%, and 95.1% in group A, 80.7%, 99.1%, and %92.9 in group B, 70.0%, 98.9%, and 95.8% in group C nodules, respectively. The prevalence of papillary thyroid cancer (PTC) and incidental PTC were 44.2% (n = 164) and 6.4% (n = 24), respectively. Malignancy rate was more frequent in group A when compared to groups B and C (P < 0.01). Nodule size was positively associated with follicular cancer risk (P = 0.009). The thyroid stimulating hormone level was positively associated with malignancy (P = 0.02) and optimal cut‐off value was 0.96 mIU/L. False‐negative rate was 8.0%, 19.3%, and 30.0% in groups A, B, and C nodules, respectively. Conclusions Although the malignancy rate was low in nodules ≥30 mm, diagnostic surgery for large nodules should be considered because of decreased reliability of FNAC, ineffectiveness of clinical and sonographic criteria. False‐negative rate was relatively low and malignancy rate was high in subcentimeter nodules, supporting the accuracy of FNAC.

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“…Moreover, Albuja-Cruz et al reported that there was no significant difference between the >4 cm group and the <4 cm group in terms of malignancy (p=0.91) [15]. Moreover, Megwalu et al have studied nodules ≥4 cm and have not detected an association between nodule size and malignancy (p=0.7) [16]. In addition, Cavallo et al reported that thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates [17].…”

Section: Discussionmentioning

confidence: 99%

Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care Hospital in Saudi Arabia

Al‐Hakami¹,

Alqahtani²,

Alahmadi³

et al. 2020

Cureus

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Background Thyroid nodules have become relatively common in clinical practice, and their prevalence increases with age. The majority of thyroid nodules are benign, with 5-15% being malignant. There are a number of well-established predictors of malignancy in thyroid nodules, but thyroid nodule size has been a cause for concern for many researchers and results of the studies are still controversial about their probability of malignancy. Up to the current knowledge, there is no published study that evaluates if thyroid nodule size is associated with the risk of malignancy in Saudi Arabia, so in this study, we aim to find that. Methods This is a retrospective study of 987 patients who underwent thyroid nodule fine-needle aspiration (FNA) and subsequent thyroidectomy for thyroid nodules measuring ≥ 1 cm. Results Thyroid cancer was more prevalent in males than females, and in patients who were older than or equal to 45 years. Nodular size of 1-1.9 cm was more prevalent among cancer patients than in benign cases (p<0.001). Conclusions The highest malignancy risk was observed in nodules <2 cm and no increase in malignancy risk for nodules >2 cm. Nevertheless, when examined by type of thyroid malignancy, the rate of follicular carcinoma and other rare malignancy increased with increasing nodule size.

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Risk of Malignancy in Thyroid Nodules 4 cm or Larger

Cited by 28 publications

References 25 publications

Malignancy risk for thyroid nodules larger than 4 cm and diagnostic reliability of ultrasound-guided FNAB results

Malignancy risk for thyroid nodules larger than 4 cm and diagnostic reliability of ultrasound-guided FNAB results

The influence of thyroid nodule size on the diagnostic efficacy and accuracy of ultrasound guided fine‐needle aspiration cytology

Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care Hospital in Saudi Arabia

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