management of thyroid nodules

PURPOSE: Radiofrequency ablation (RFA) is an effective and safe modality for the treatment of thyroid nodules. Nodule rupture is a major complication of RFA. There is little known on the natural history of nodule rupture due to a lack of clinical experience and no consensus on its management. A comprehensive review of nodule rupture presentation, diagnosis, and management is needed. METHODS: We report a case of nodule rupture and conduct a literature review. A total of 33 patients experiencing nodule rupture after RFA were included, and their clinical presentation, management, and outcomes were collected and analyzed...

Papillary thyroid carcinoma (PTC) with marked cystic formation (CPTC) is not a subtype of PTC, and its clinical characteristics have not been fully investigated. This study aimed to clarify the clinical and pathological characteristics of CPTC and propose important indicators for its clinical management. 33 CPTC nodules with cystic areas occupying >50% of their volume were examined. Two matched controls (AC) were prepared, one with tumor diameter matched for whole tumor diameter (WTD) of CPTCs (WTD-MC) and the other with tumor diameter matched for solid area diameter (SAD) of CPTCs...

PURPOSE: The importance of structured radiology reports has been fully recognized, as they facilitate efficient data extraction and promote collaboration among healthcare professionals. Our purpose is to assess the accuracy and reproducibility of ChatGPT, a large language model, in generating structured thyroid ultrasound reports. METHODS: This is a retrospective study that includes 184 nodules in 136 thyroid ultrasound reports from 136 patients. ChatGPT-3.5 and ChatGPT-4...

BACKGROUND: Treating hyperthyroidism induced by autonomously functioning thyroid nodules (AFTNs) through radioactive iodine and surgery often results in undesirable hypothyroidism. Radiofrequency ablation (RFA) has arisen as a favorable option. European guidelines recommend RFA for small AFTN in young patients, aiming to restore normal thyroid function and avoid irradiation. The procedure, costing between 500 and 1,000 euros, is conducted in outpatient clinics and takes 15 to 40 minutes...

OBJECTIVE: Patient preferences regarding thyroid nodules are poorly understood. Our objective is to (1) employ a discrete choice experiment (DCE) to explore risk tradeoffs in thyroid nodule management, and (2) segment respondents into preference phenotypes. STUDY DESIGN: DCE. SETTING: Thyroid surgery clinic, online survey. METHODS: A DCE including 5 attributes (cancer risk, voice concerns, incision/scar, medication requirement, follow-up frequency) was refined with qualitative patient and physician input...

Background Only about 5% of palpable thyroid nodules are malignant; the rest are entirely benign. In order to reduce the number of unnecessary treatments and properly identify situations that need surgical intervention, it is essential to distinguish between benign and malignant lesions prior to surgery. There exists a "grey zone" in thyroid cytology characterized by a significant decrease in diagnostic accuracy, making it difficult to precisely classify the lesion and leading to discrepancies. Aims and objectives The study aims to accomplish the following objectives: (1) assess the prevalence of thyroid lesions according to age and sex; (2) evaluate the accuracy of the fine needle aspiration cytology (FNAC) in diagnosing thyroid conditions; and (3) investigate the causes of cytohistological discordance within the context of this study...

BACKGROUND: There is currently insufficient data to validate adult-based US risk stratification systems (RSSs) for the identification of malignant thyroid nodules in a pediatric population. METHODS: From October 2016 and May 2023, 173 thyroid nodules of pediatric patients (age ≤ 18 years) with definitive pathology results and ultrasound (US) examination within 1 month before surgery or fine-needle aspiration (FNA) biopsy in our institution were enrolled in this study...

Thyroid nodules are a common occurrence, and although most are non-cancerous, some can be malignant. The American College of Radiology has developed the Thyroid Imaging Reporting and Data System (TI-RADS) to standardize the interpretation and reporting of thyroid ultrasound results. Within TI-RADS, a category 4 designation signifies a thyroid nodule with an intermediate level of suspicion for malignancy. Accurate classification of these nodules is crucial for proper management, as it can potentially reduce unnecessary surgeries and improve patient outcomes...

UNLABELLED: There is an ongoing debate about the reasons behind the increasing incidence of thyroid cancer in the last two to three decades. Here, we investigate how thyroid nodules were detected in a large series of consultations for thyroid nodular pathology. METHODS: In total, 576 patients were analyzed, with a total of 1014 nodules described. RESULTS: In 347 (60.2%) cases, the diagnosis of a thyroid nodule was incidental, mostly during imaging tests for other reasons...

BACKGROUND: Fluorodeoxyglucose uptake on positron emission tomography imaging has been shown to be an independent risk factor for malignancy in thyroid nodules. More recently, a new positron emission tomography radiotracer-Gallium-68 DOTATATE-has gained popularity as a sensitive method to detect neuroendocrine tumors. With greater availability of this imaging, incidental Gallium-68 DOTATATE uptake in the thyroid gland has increased. It is unclear whether current guideline-directed management of thyroid nodules remains appropriate in those that are Gallium-68 DOTATATE avid...

BACKGROUND: Thyroid nodule (TN) patients in China are subject to overdiagnosis and overtreatment. The implementation of existing technologies such as thyroid ultrasonography has indeed contributed to the improved diagnostic accuracy of TNs. However, a significant issue persists, where many patients undergo unnecessary biopsies, and patients with malignant thyroid nodules (MTNs) are advised to undergo surgery therapy. METHODS: This study included a total of 293 patients diagnosed with TNs...

BACKGROUND: Molecular triage of indeterminate thyroid aspirates offers the opportunity to stratify the risk of malignancy (ROM) more accurately. Here we examine our experience with ThyroSeq v3 testing. METHODS: We analyzed 276 of 658 (42%) fine needle aspiration samples classified as indeterminate thyroid nodules using ThyroSeq v3 (Sept 2017-Dec 2019). The test provides a ROM and detects specific mutations. Surgical diagnoses were reviewed. RESULTS: Of 276 ThyroSeq-tested cases, 42% (n = 116) harbored genetic alterations, whereas 64% (n = 74) had surgical follow-up...

The rising occurrence and notable public health consequences of skin cancer, especially of the most challenging form known as melanoma, have created an urgent demand for more advanced approaches to disease management. The integration of modern computer vision methods into clinical procedures offers the potential for enhancing the detection of skin cancer . The UNet model has gained prominence as a valuable tool for this objective, continuously evolving to tackle the difficulties associated with the inherent diversity of dermatological images...

Introduction Thyroid gland disorders, such as goiters or tumor masses, are the result of localized or systemic aberrations of the thyroid gland. The purpose of this research was to see how effective fine needle aspiration cytology (FNAC) was in detecting thyroid swelling in patients with thyroid swelling. It is critical to be able to differentiate between benign and malignant thyroid nodules to reduce unnecessary thyroid surgeries. It is hypothesized that FNAC is not a reliable diagnostic tool to detect thyroid nodules in patients with thyroid swelling and that there is a significant variation between the number of thyroid nodules detected by FNAC and the number of thyroid nodules that were eventually diagnosed as malignant by surgery...

The high prevalence of thyroid nodules and increased availability of neck ultrasound have led to an increased incidence of diagnostic thyroid fine needle aspirations, with approximately 20% yielding indeterminate results. The recent availability of molecular tests has helped guide the clinical management of these cases. This paper aims to review and compare three main commercially available molecular cytology platforms in the U.S.-Afirma GSC, Thyroseq GC, and ThyGeNEXT + ThyraMIR. Sequential improvements of the Afirma GSC and Thyroseq GC tests have increased positive and negative predictive values, sensitivity, and specificity...

CONTEXT: A rare, large single centre study covering all long-term health outcomes of paediatric allogeneic HSCT survivors, to provide comprehensive local data, and identify gaps and future directions for improved care. OBJECTIVE: To document endocrine sequelae and other late effects of all HSCT recipients. DESIGN: Retrospective review. SETTING: Royal Children's Hospital Melbourne. PATIENTS: 384 children and adolescents received HSCT...

The increased detection of thyroid nodules in the human population has led to an increase in the number of thyroid surgeries without an improvement in survival outcomes. Though the choice for surgery is straightforward in malignant thyroid nodules, the decision is far more complex in those nodules that get categorized into indeterminate thyroid nodules (ITN) by fine needle aspiration. Therefore, there is a pressing need to develop a tool that will aid in decision-making among the ITN. In this context, the development of various molecular testing (MT) panels has helped to confirm or rule out malignancy, reducing unnecessary surgeries and potentially guiding the extent of surgery as well...

BACKGROUND/OBJECTIVE: Cribriform-morular thyroid carcinoma (CMTC) was considered a variant of papillary thyroid carcinoma (PTC) but is a separate entity in the 2022 World Health Organization classification. CMTC has an association with familial adenomatous polyposis (FAP). Our objective is to report a case of CMTC who was subsequently diagnosed with FAP, to highlight these associated entities and implications for management. CASE REPORT: A 15-year-old female with a history of iron-deficiency anemia and alpha-gal syndrome presented with several years of goiter and dysphagia...

INTRODUCTION: High-resolution ultrasonography devices have led to the increased detection of thyroid nodules and the need for fine-needle aspiration biopsy (FNAB). However, FNAB is an invasive procedure that can cause discomfort and pain. Music therapy has been used for centuries to alleviate pain, and our clinical trial was conducted to investigate its impact on pain scores during thyroid FNAB. MATERIALS AND METHODS: We conducted a randomized, controlled clinical trial, including adult patients undergoing thyroid FNAB...

INTRODUCTION: Thyroglossal duct cysts (TDCs) can be detected in several different locations, although in the literature, intrathyroidal presentations are rare. CASE PRESENTATION: Our patient was a 56-year-old woman who was diagnosed with hypothyroidism and presented with a right-lateral neck mass that was clinically indistinguishable from a thyroid nodule. Cytology revealed normal-looking squamous cells on fine-needle aspiration. Right hemithyroidectomy was performed, and histopathological examination revealed a cyst lined by squamous epithelium that was consistent with a thyroglossal duct cyst (TDC)...