Thyroid Nodular Disease in Pregnancy: Current Diagnosis and Management

Rosen, Irving B.; Korman, Mark; Walfish, Paul G.

doi:10.1097/00003081-199703000-00009

Cited by 53 publications

(40 citation statements)

References 10 publications

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“…No new thyroid nodules discovered on US were palpable. These data indicate that pregnancy is associated with an increase in the size of preexisting nodules and with the appearance of newly developed thyroid nodules, possibly because of the negative iodine balance that frequently occurs during pregnancy (195).…”

Section: Effects Of Pregnancy On Nodular Thyroid Diseasementioning

confidence: 73%

See 1 more Smart Citation

American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

Gharib¹,

Papini²,

Paschke³

et al. 2010

Endocrine Practice

836

819

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Section: Effects Of Pregnancy On Nodular Thyroid Diseasementioning

confidence: 73%

“…Although pregnancy is a risk factor for progression of nodular thyroid disease, no available evidence indicates that levothyroxine is effective in decreasing the size or arresting the growth of thyroid nodules during pregnancy (195). Hence, levothyroxine suppressive therapy for thyroid nodules is not advisable during pregnancy.…”

Section: Benign Thyroid Nodulementioning

confidence: 99%

American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

Gharib¹,

Papini²,

Paschke³

et al. 2010

Endocrine Practice

836

819

View full text Add to dashboard Cite

“…In a study that included 61 pregnant patients with thyroid nodules, DTC was detected and histologically confirmed in 30 patients (43%) (10). In another study that included 21 patients in the same situation, DTC was detected in 8 patients (28.5%) (6).…”

Section: Discussionmentioning

confidence: 96%

“…California records have shown a prevalence of thyroid cancer detected during pregnancy in 14 out of every 100,000 live newborns, versus 4 out of every 100,000 in the general population, and it is the second most frequent cancer detected in pregnant women after breast cancer (9). Prevalence of DTC in pregnant women is estimated at 1/1,000 cases, mostly papillary carcinomas with favorable evolution (10). Thyroid cancer is likely to be asymptomatic and diagnosed by a palpable nodule found in the prenatal examination.…”

Section: Discussionmentioning

confidence: 99%

Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

Cabezón

Carrizo

Costanzo

2013

Arq Bras Endocrinol Metab

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Objective: To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy. Subjects and methods: Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. Follow-up: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131 I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated. Results: 100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. Follow-up: 5.7 ± 4.3 years; one patient had persistent disease. Conclusions: DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy. Arq Bras Endocrinol Metab. 2013;57(4):307-11

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“…Serum Tg may be monitored in the pregnant DTC patient, with a significant rise prompting detailed neck palpation and neck US. 54 …”

Section: In Pregnancymentioning

confidence: 99%

Can we interpret serum thyroglobulin results?

Clark

Franklyn

2012

Ann Clin Biochem

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Thyroglobulin (Tg) is a tumour marker for differentiated thyroid cancer. Interpretation requires a knowledge of the current thyrotropin (TSH) concentration as secretion is TSH-dependent. While a raised serum Tg may be indicative of residual or recurrent thyroid cancer, trauma to the thyroid (e.g. surgical, biopsy or due to radioiodine treatment) also causes an increase. Tg may be measured when TSH is suppressed and also following recombinant TSH (rhTSH) stimulation. Interpretation of results in pregnancy and in children is discussed. Assay bias and interference by endogenous Tg antibodies (Abs) are the main confounders in the interpretation of results. Although there is an international standard for Tg, there are large differences in results and yet there are few assay-specific clinical decision limits. Patients should therefore be monitored with the same assay. Endogenous TgAbs may cause false-negative interference in immunometric assays and may cause false-positive results in radioimmunoassay. Although the measurement of TgAbs has been advocated for predicting interference, it is now clear that interference can still occur when TgAbs have not been detected, the effect being TgAb-assay-specific. Approaches to identifying those samples where there may be interference are discussed. The laboratory should have a protocol for the investigation of possible interferences and data on the bias of the Tg assay that they use. An appreciation of the clinical uses of the service is required as an understanding by endocrinologists, oncologists and endocrine surgeons of the analytical limitations of the service.

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Thyroid Nodular Disease in Pregnancy: Current Diagnosis and Management

Cited by 53 publications

References 10 publications

American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

American Association Of Clinical Endocrinologists, Associazione Medici Endocrinologi, And European Thyroid Association Medical Guidelines For Clinical Practice For The Diagnosis And Management Of Thyroid Nodules

Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

Can we interpret serum thyroglobulin results?

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