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management of thyroid nodules

Su Min Ha, Jung Hwan Baek, Young Jun Choi, Sae Rom Chung, Tae Yon Sung, Tae Yong Kim, Jeong Hyun Lee
OBJECTIVE: Some authors have found little or no diagnostic benefit from repeated biopsy of benign thyroid nodules. However, to our knowledge, integration of Thyroid Imaging Reporting and Data System (TIRADS) guidelines with one biopsy for sufficient benign thyroid nodule diagnosis has not been previously described. We investigated malignancy rate and probability by using various malignancy stratification systems in initially biopsy-proven benign nodules and sought to determine their clinical relevance in management of benign thyroid nodules...
June 19, 2018: European Radiology
Y M Guo, J L Huo, R Qu, X C Hu, D S Liu, Z Y Chen, W Hong
Objective: To evaluate the differences of smear quality and diagnostic accuracy between thyroid nodules and fine needle nonaspiration cytology (FNNAC) and fine needle aspiration cytology (FNAC). Method: Databases were used to search the literature on FNNAC and FNAC. All statistical analyses were performed using Review Manager 5.3 Software. Result: A total of 10 studies were included in the study. Meta-analysis showed no significant difference in FNNAC and FNAC between low, middle and high quality smears. There was no significant difference in diagnostic accuracy...
June 5, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Mark R Kho, Agustina D Abelardo
We present a rare and interesting case of a 35-year-old woman who initially underwent an uneventful wide excision for a 13 cm left benign phyllodes tumour. She then noted a slowly growing left thyroid nodule 8 months postsurgery which on thyroidectomy 4 years later was shown to be a 6.9cm isolated thyroid metastasis from the phyllodes tumour. As this may be the first reported such case in the literature, implications on histological classification, predictive factors for disease progression, mechanisms of metastasis, and evaluation, management and surveillance of benign phyllodes tumours and thyroid nodule/s with a history of phyllodes tumour can thus be significantly impacted...
June 17, 2018: BMJ Case Reports
Yan Zhuang, Cheng Li, Zhan Hua, Ke Chen, Jiang Li Lin
BACKGROUND: Thyroid imaging reporting and data system (TIRADS) is the assessment of a risk stratification of thyroid nodules, usually using a score. However, there is no consensus as to the version of TIRADS for reporting the results of thyroid ultrasound in clinic. The objective of this study is to develop a practical TIRADS with which to categorize thyroid nodules and stratify their malignant risk. METHODS: A TIRADS scoring system was developed to provide more decision levels than standard scoring through the selection of the ultrasound features which include the calcification shape, margins, taller-than-wide, internal echo, blood flow quantization of features, setting of the weight, and calculation of the score...
June 18, 2018: Biomedical Engineering Online
Juan P Brito, Jae Hoon Moon, Rebecca Zeuren, Sung Hye Kong, Yeo Koon Kim, Nicole M Iñiguez-Ariza, June Young Choi, Kyu Eun Lee, Ji-Hoon Kim, Ian Hargraves, Victor Bernet, Victor Montori, Young Joo Park, R Michael Tuttle
BACKGROUND: The 2015 American Thyroid Association guidelines recognize active surveillance as an alternative to immediate surgery in patients with papillary microcarcinomas (PMCs). As a way to incorporate active surveillance as one of the management options for patients with PMCs, we describe the development and initial testing of a tool to support conversations between clinicians and patients with PMCs considering treatment options. METHODS: Thyroid Cancer Treatment Choice was developed using an iterative process based on the principles of interaction, design and participatory action research...
June 15, 2018: Thyroid: Official Journal of the American Thyroid Association
Zunfu Ke, Yihao Liu, Yunjian Zhang, Jie Li, Ming Kuang, Sui Peng, Jinyu Liang, Shuang Yu, Lei Su, Lili Chen, Cong Sun, Bin Li, Jessica Cao, Weiming Lv, Haipeng Xiao
Differentiation of benign and malignant thyroid nodules is crucial for clinical management. Here, we explored the efficacy of next‑generation sequencing (NGS) in predicting the classification of benign and malignant thyroid nodules and lymph node metastasis status, and simultaneously compared the results with ultrasound (US). Thyroline was designed to detect 15 target gene mutations and 2 fusions in 98 formalin‑fixed, paraffin‑embedded (FFPE) tissues, including those from 82 thyroid cancer (TC) patients and 16 patients with benign nodules...
June 14, 2018: Oncology Reports
Yongwen Zhang, Fanrong Meng, Lianqing Hong, Lanfang Chu
The study is aimed to establish a simplified and practical tool for analyzing thyroid nodules. A novel risk score model was designed, risk factors including patient history, patient characteristics, physical examination, symptoms of compression, thyroid function, ultrasonography (US) of thyroid and cervical lymph nodes were evaluated and classified into high risk factors, intermediate risk factors, and low risk factors. A total of 243 thyroid nodules in 162 patients were assessed with risk score system and Thyroid Imaging-Reporting and Data System (TI-RADS)...
June 12, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Beata Bode-Lesniewska, Beatrix Cochand-Priollet, Patrizia Straccia, Guido Fadda, Massimo Bongiovanni
Thyroid nodules are common and increasingly detected due to recent advances in imaging techniques. However, clinically relevant thyroid cancer is rare and the mortality from aggressive thyroid cancer remains constant. FNAC (Fine Needle Aspiration Cytology) is a standard method for diagnosing thyroid malignancy and the discrimination of malignant nodules from goiter. As the examined nodules on thyroid FNAC are often small incidental findings, it is important to maintain a low rate of undetermined diagnoses requiring further clinical work up or surgery...
June 9, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
Anupama Roy Chowdhury, Jack Kian Ch'ng, Choon Chieh Tan
Papillary thyroid cancer (PTC) can present as a thyroid cyst. In its more aggressive form, PTC may be multifocal in nature and is associated with a poorer prognosis. In patients whom PTC is diagnosed incidentally after a diagnostic lobectomy, the decision whether to offer completion thyroidectomy is sometimes challenging to make if such patients fall in the 'low-to-intermediate' risk category. We present a case of a 55-year-old lady who had a predominantly cystic left thyroid nodule with no suspicious features on ultrasound as well as 2 subcentimetre simple right-sided cysts...
2018: Case Reports in Medicine
Pablo Valderrabano, Melissa J McGettigan, Cesar Lam, Laila Khazai, Zachary J Thompson, Christine H Chung, Barbara A Centeno, Bryan McIver
BACKGROUND: The 2015 American Thyroid Association (ATA) guidelines recommend using a classification based on sonographic patterns to set the size-threshold for biopsies. Each pattern is associated with a distinct estimated rate of malignancy that, we hypothesize, should stratify the risk of malignancy of cytologically indeterminate thyroid nodules. METHODS: Ultrasound images of 463 indeterminate thyroid nodules (38% atypia/follicular lesions of undetermined significance; 62% follicular neoplasms) with histological follow-up consecutively evaluated between 10/2008 and 06/2015 at our academic cancer center were independently evaluated by 3 observers and classified into one of the five sonographic patterns proposed by the ATA...
May 31, 2018: Thyroid: Official Journal of the American Thyroid Association
Fernando Fernández-Ramírez, Luis M Hurtado-López, Mario A López, Eva Martínez-Peñafiel, Norma E Herrera-González, Luis Kameyama, Omar Sepúlveda-Robles
Thyroid cancer is the most frequent endocrine malignancy, and its incidence and prevalence are increasing worldwide. Despite its generally good prognosis, the observed mortality rates are higher in the less-developed regions. This indicates that timely diagnosis and appropriate initial management of this disease are important to achieve a positive outcome. We performed an observational study in order to describe the frequency of the BRAF 1799T>A mutation in Mexican mestizo patients with thyroid nodules, a scarcely studied ethnic group with large populations...
2018: BioMed Research International
Habib G Zalzal, Jeffson Chung, Jessica A Perini
Background: Undifferentiated anaplastic carcinoma rarely develops from chronic hyperthyroidism. Although acute hyperthyroidism can develop prior to anaplastic transformation, chronic hyperthyroidism was thought to be a protective measure against thyroid malignancy. Methods: A 79-year-old female presented acutely to the hospital with dyspnea. She had been taking methimazole for chronic hyperthyroidism due to toxic thyroid nodules, previously biopsied as benign. Upon admission, imaging showed tracheal compression, requiring a total thyroidectomy with tracheostomy for airway management...
2018: Case Reports in Endocrinology
Kelsi E Deaver, Bryan R Haugen, Nikita Pozdeyev, Carrie B Marshall
OBJECTIVE: The second edition Bethesda System for Reporting Thyroid Cytology estimates 6-18% malignancy rate of category III (B3) and 10-40% for category IV (B4) nodules; however, reported malignancy rates have considerable variability among institutions. Use of molecular classifiers (including Afirma Gene Expression Classifier, GEC) can be utilized in management of thyroid nodules. Our objective was to analyze malignancy rates of B3 and B4 nodules and determine clinical outcomes of GEC Benign nodules...
May 23, 2018: Clinical Endocrinology
Chiaw Ling Chng, Hong Chang Tan, Chow Wei Too, Wei Ying Lim, Priscilla Pei Sze Chiam, Ling Zhu, Nivedita Vikas Nadkarni, Adoree Yi Ying Lim
INTRODUCTION: We aimed to compare the malignancy risk stratification of histologically proven thyroid nodules using the 2015 American Thyroid Association (ATA) Management Guidelines, 2014 British Thyroid Association (BTA) Guidelines for the Management of Thyroid Cancer and Thyroid Imaging Reporting and Data System (TIRADS). METHODS: Thyroid nodules measuring > 1 cm resected over 5.5 years were retrospectively studied. Information like gender and age, and cytology and histopathology results were collected...
May 18, 2018: Singapore Medical Journal
Sae Rom Chung, Young Jun Choi, Chong Hyun Suh, Hwa Jung Kim, Jong Jin Lee, Won Gu Kim, Tae-Yon Sung, Yu-Mi Lee, Dong Eun Song, Jeong Hyun Lee, Jung Hwan Baek
BACKGROUND: To stratify the risk of malignancy in thyroid incidentalomas detected on 18F-FDG PET/CT using ultrasound features according to guidelines for thyroid nodules and thereby suggests management plans. METHODS: From a historical cohort of 96 942 consecutive patients who underwent 18F-FDG PET/CT between October 2008 and September 2015, 1342 patients with 1364 nodules underwent ultrasound evaluation for focal uptake in thyroid gland, with a final diagnosis made for 877 patients with 907 nodules which included in our study...
May 15, 2018: Thyroid: Official Journal of the American Thyroid Association
F Pacini, F Basolo, R Bellantone, G Boni, M A Cannizzaro, M De Palma, C Durante, R Elisei, G Fadda, A Frasoldati, L Fugazzola, R Guglielmi, C P Lombardi, P Miccoli, E Papini, G Pellegriti, L Pezzullo, A Pontecorvi, M Salvatori, E Seregni, P Vitti
BACKGROUND: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. METHODS: Six scientific Italian societies entitled to cure thyroid cancer patients (the Italian Thyroid Association, the Medical Endocrinology Association, the Italian Society of Endocrinology, the Italian Association of Nuclear Medicine and Molecular Imaging, the Italian Society of Unified Endocrine Surgery and the Italian Society of Anatomic Pathology and Diagnostic Cytology) felt the need to develop a consensus report based on significant scientific advances occurred in the field...
May 4, 2018: Journal of Endocrinological Investigation
C Kocaoglu, M S Durmaz, M Sivri
INTRODUCTION: Shear wave elastography (SWE) is a new technology and non-invasive ultrasound device that can measure tissue rigidity and elasticity. OBJECTIVE: This controlled prospective study aimed to demonstrate using SWE whether there was a difference between the elasticity of testes with non-communicating (NC) hydrocele in infants and toddlers and elasticity of controls' testes without hydrocele, and to reveal quantitative values of elasticity reflecting histological findings...
April 23, 2018: Journal of Pediatric Urology
E Chaigneau, G Russ, B Royer, C Bigorgne, M Bienvenu-Perrard, A Rouxel, L Leenhardt, L Belin, C Buffet
CONTEXT: Thyroid nodules with cytological indeterminate results represent a daily and recurrent issue for patient management. OBJECTIVE: The primary aim of our study was to determine if TIRADS (Thyroid Imaging Reporting and Data System) could be used to stratify the malignancy risk of these nodules and to help in their clinical management. Secondary objective was to estimate if this risk stratification would change after reclassification of encapsulated non-invasive follicular variant of papillary carcinomas (FVPTC) as non-invasive follicular thyroid neoplasm (NIFTP)...
July 2018: European Journal of Endocrinology
L Tu, S L Wang, Q Dong, H Y Song, X T Li, C P Tan, X Dong
Objective: We evaluated the effect of low-dose of ionizing radiation on thyroid function of medical occupational group with long-term exposure; furthermore; we analyzed the relationship between the thyroid hormones and the risk factors; such as exposure length; department. Ultimately; providing the scientific basis for setting the ionizing radiation protection standards. Methods: The population who engaged radiodiagnosis and radiotherapy in a tertiary-A hospital were set up as occupational exposure; 724 medical professionals as the research object...
February 20, 2018: Chinese Journal of Industrial Hygiene and Occupational Diseases
M Nordio, S Basciani
OBJECTIVE: The anticancer effect of myo-inositol (MI) is catching researchers' attention worldwide. Thyroid nodules (TNs) have been detected by ultrasound (US) in up to 76% of the general population and, although most of them are benign, thyroid cancer is the most common malignancy of the endocrine system. PATIENTS AND METHODS: A retrospective, observational study was conducted in 642 patients with suspected hypothyroidism undergoing US. The analysis was addressed exclusively to patients with subclinical hypothyroidism (SCH) or thyroid-stimulating hormone (TSH) levels borderline associated to TNs classified as class I and II; 1 group (control, no...
April 2018: European Review for Medical and Pharmacological Sciences
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