The incidental thyroid nodule

Abstract

Incidental thyroid nodules that are found on an imaging study performed for reasons other than thyroid pathology represent a common scenario encountered by health care providers. The initial workup for these nodules comprises a thorough history and physical examination, thyroid function tests, a dedicated thyroid ultrasound, and fine-needle aspiration of any suspicious lesions. Management ranges from observation and reassurance to surgical resection and depends on the cytologic diagnosis. In cases of cytologically indeterminate or discordant nodules, surgical excision (lobectomy) offers a definitive diagnosis, although molecular testing or a reasonable period of observation may be useful as less invasive adjuncts. CA Cancer J Clin 2018;68:97-105. © 2018 American Cancer Society.

Radiation and Second Primary Thyroid Cancer Following Index Head and Neck Cancer

“…3,17,18 Besides individuals with a history of cancer, thyroid incidentalomas are also prevalent among individuals with other conditions; recent studies reporting that the prevalence rate of thyroid incidentaloma or nodules may be up to 60% in the general population. 19,20 Although there is existing literature on increased risk of developing thyroid cancer following radiation exposure for primary cancers, we found no significantly increased risk of developing SPTC among HNC survivors who received radiation alone, or chemoradiation, compared with those that did not receive either treatments. Our findings differ from previous studies.…”

“…This might explain the dose‐dependent, increased risk of SPTC following radiation treatment for several pediatric and other cancers, as previously described in the literature . Besides individuals with a history of cancer, thyroid incidentalomas are also prevalent among individuals with other conditions; recent studies reporting that the prevalence rate of thyroid incidentaloma or nodules may be up to 60% in the general population …”

Computed Tomography Radiomics for the Preoperative Prediction of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma: Development and External Validation

“…In terms of our previous study and other reports [25][26][27][28], the following inclusion criteria were established for metastatic LNs: (i) no other de nite cervical LN lesion, such as tuberculosis and lymphoma; (ii) selected from the cervical LN group with two LN metastases con rmed by pathology; (iii) short diameter of LN ≥ 5 mm; (iiii) the LN with highest score and ≥ two points (the classic signs of PTC LN metastasis including maximum short diameter, short diameter/long diameter ≥ 1/2, highest enhancement, cystic degeneration/necrosis, and microcalci cation were assigned one point, respectively). The inclusion criteria for non-metastatic LNs met the following three points: (i) no other de nite cervical LN lesion, such as tuberculosis and lymphoma; (ii) selected from the cervical LN groups with no LN metastasis con rmed by pathology; (iii) the LN with largest diameter and a short diameter ≥ 5 mm within the groups mentioned in point (ii).…”

“…Currently, the preoperative CT evaluation of PTC cervical LN metastasis mainly relies on the signs such as microcalci cation, necrotic or cystic degeneration, uniform or non-uniform high enhancement, and minimum/maximum diameter > 0.5 [25,26]. However, subjective evaluation of these signs by radiologists has limited the performance for the diagnosis of LN metastasis.…”

The KWAK TI‐RADS and 2015 ATA guidelines for medullary thyroid carcinoma: Combined with cell block‐assisted ultrasound‐guided thyroid fine‐needle aspiration

“…The incidence of thyroid nodules has rapidly increased with the widespread use of ultrasound (US) screening . Papillary thyroid carcinoma (PTC) accounts for > 80% of primary thyroid malignancies, but its prognosis is good .…”