Thyroid Nodules: Rational Management

Wong, Christopher; Wheeler, Malcolm H.

doi:10.1007/s002680010175

Cited by 137 publications

(113 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Goiter and/or thyroid nodules are the most prevalent endocrine conditions in the world, affecting over 500 million people with prevalence rates reaching up to 30 % [1,2]; local neck symptoms range from 13 to 50 % in patients undergoing surgery for benign nodular diseases [3,4].…”

Section: Introductionmentioning

confidence: 99%

How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

Cusimano

Macaione

Fiorentino

2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Swallowing, voice disorders, throat discomfort and subjective neck discomfort are usually reported by patients with a known thyroid nodule and are correlated to nodular thyroid disease itself. Moreover, in endemic goitrous areas, total thyroidectomy (TT) is the most frequently performed surgical procedure. We are used to relate swallowing, voice and throat discomfort to the mechanical effects of nodular goiter or to thyroidectomy itself, but in both these cases the relationship between symptoms and the thyroid mass or its removal is not always clear or easily demonstrated. How can we explain the persistence of local neck symptoms after TT? And how can TT worsen the dysphagic or dysphonic disorders attributed to the goiter's effect over the surrounding structures? During these years, many articles have analyzed the relationship between the thyroid disease and the laryngopharyngeal reflux, finding more and more evidences of their consensuality, leading to important new management considerations and notable medico-legal implications; if the reason of local neck symptoms is not the thyroid disease, we have to study and specially cure the reflux disease, with specific test and drugs. Therefore, the aim of our study, relying on the published literature, was to investigate how, in demonstrated presence of reflux laryngopharyngitis in patients with nodular goiter and local neck symptoms before and after uncomplicated TT, the surgery could influence our anti-reflux mechanism analyzing the anatomical connection as well as the functional coordination; can we play a part in the post-operative persistence of swallowing and voice alterations and throat discomfort?

show abstract

Section: Introductionmentioning

confidence: 99%

How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

Cusimano

Macaione

Fiorentino

2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…[8][9][10][11][12] In order to determine whether FNA is indicated, evaluation of a palpable thyroid nodule requires a complete clinical history and physical examination directed to the thyroid gland and cervical lymph-node chains, as well as a serum thyrotropin (TSH) measurement to guide the strategy for diagnostic imaging. [12][13][14][15] Patients with normal or elevated TSH should next undergo an ultrasound examination, whereas those with a suppressed TSH level (Ͻ0.1 mIU/L) should have a radionuclide thyroid scan performed. 6,8,[10][11][12][13][14]16 In general, functioning thyroid nodules in the absence of significant clinical findings do not require investigation by FNA.…”

Section: Indications For Performing An Fna Of a Thyroid Nodulementioning

confidence: 99%

Thyroid Aspiration Cytology: Current Status

Layfield¹,

Cibas²,

Gharib³

et al. 2009

CA: A Cancer Journal for Clinicians

156

115

View full text Add to dashboard Cite

In the adult population, thyroid nodules are common and are increasingly detected by ultrasound examination or other scanning techniques. Depending on their size and ultrasonographic features, these nodules may require further investigation, including tissue diagnosis. Fine-needle aspiration (FNA) has become the predominant method to obtain tissue for microscopic analysis. In October 2007, the National Cancer Institute sponsored a conference to review the state of the science for the use of FNA in the management of thyroid nodules. This conference reviewed indications for thyroid FNA and pre-FNA requirements, training and credentialing, techniques for thyroid FNA, diagnostic terminology and morphologic criteria, utilization of ancillary studies, and post-FNA testing and treatment options. The results of those discussions have been published in both print and electronic versions. The aim of the current article was to discuss indications for FNA, diagnostic terminology, and post-FNA options, issues that are important to physicians who are managing patients with thyroid nodules. CA Cancer J Clin 2009;59: 99-110.

show abstract

“…In particular, thyroid nodules, which are the second most common endocrine system disease, have received increasing attention (2,3). Conventional ultrasonography was previously considered to be the preferred diagnostic tool for patients with thyroid disease, and has been reported as the most effective method for the clinical assessment and treatment of this disorder (4). However, with the development of high-frequency ultrasonography, the early detection of thyroid lesions has improved (5).…”

Section: Introductionmentioning

confidence: 99%

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

Zhang

Wang

et al. 2015

Oncology Letters

View full text Add to dashboard Cite

Abstract. The present study aimed to evaluate the value of elasticity imaging and contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of papillary thyroid microcarcinoma (TMC). In total, 73 patients exhibiting a total of 80 small thyroid nodules, which were difficult to diagnose using conventional ultrasonography, underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination, and the accuracy of the 2 diagnostic methods was compared. The correct diagnostic rate of CEUS was 85% (68/80 nodules), of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. By contrast, the accuracy rate of the elasticity imaging, based on the 5-point diagnostic method, was 92.5% (74/80 nodules), of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. Furthermore, elasticity imaging in the diagnosis of TMC was determined to have sensitivity, specificity and accuracy rates of 94.0, 90.0 and 92.5%, respectively, whereas the corresponding rates for CEUS were 88.0, 80.0 and 85.0%, respectively. Thus, ultrasonographic elasticity imaging exhibited significant advantages in the diagnosis of TMC compared with CEUS (P<0.05). The use of CEUS demonstrates no evident advantage in the diagnosis of TMC; however, an elasticity score of ≥3 is of high clinical value as a diagnostic criterion for TMC. IntroductionAt present, there are >300 million individuals with thyroid disease worldwide (1). In particular, thyroid nodules, which are the second most common endocrine system disease, have received increasing attention (2,3). Conventional ultrasonography was previously considered to be the preferred diagnostic tool for patients with thyroid disease, and has been reported as the most effective method for the clinical assessment and treatment of this disorder (4). However, with the development of high-frequency ultrasonography, the early detection of thyroid lesions has improved (5). Thus, high-frequency ultrasonography has become the preferred method for the clinical evaluation and treatment of thyroid disease (6). Accordingly, thyroid nodules identified on cervical ultrasonographic examination account for 50% of all reported thyroid nodules (7). Papillary thyroid microcarcinoma (TMC) is an early-stage subtype of thyroid carcinoma with a maximum tumor diameter of ≤10 mm and a frequency of 65-99% among all thyroid carcinomas (8). However, nodular thyroid lesions measuring ≤1 cm in diameter may possess features that are characteristic of different types of lesions, commonly resulting in an uncertain diagnosis during pre-operative conventional ultrasonography (8). Therefore, the development of novel pre-operative diagnostic methods is required.In previous years, contrast-enhanced ultrasound (CEUS) and ultrasonic elastography (UE) have become popular research topics, and these modalities have been proposed for the diagnosis and differential diagnosis of thyroid lesion...

show abstract

Thyroid Nodules: Rational Management

Cited by 137 publications

References 49 publications

How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

Thyroid Aspiration Cytology: Current Status

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

Contact Info

Product

Resources

About