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Evaluation of Thyroid Nodules

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Surgery of the Thyroid and Parathyroid Glands

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Abstract

Thyroid nodules are very frequent findings, and their prevalence steadily increases with age. However, clinically significant thyroid cancer is a rare malignancy, and death from thyroid cancer is even less common with an estimated annual death rate of 0.25 per 100,000 in the US population. Moreover, the ever-increasing discovery of thyroid nodules by high-resolution radiological imaging procedures performed for other indications raises the problem of how incidentally discovered lesions should be investigated in a cost-effective and safe manner to identify the rare patient with a clinically significant malignancy.

In this chapter, the clinical criteria prompting the evaluation of thyroid nodules are presented, as is the currently recommended diagnostic approach that principally relies on fine-needle aspiration (FNA) biopsies. The clinical implications of the different cytological diagnoses are reviewed, with special emphasis on the management of indeterminate, microfollicular lesions. The role of ultrasound imaging in nodular thyroid disease management and its performance in evaluating the risk of malignancy are commented upon. Finally, the evidence for and against suppressive thyroid hormone therapy for benign thyroid nodules and multinodular goiters is discussed.

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Authors and Affiliations

  1. Department of Endocrinology and Diabetes, Rue du Môle 3, CH-2000, Neuchâtel, Switzerland

    Michel Procopiou

  2. Innere Medizin, Stadtspital Triemli Zürich, Birmensdorferstrasse 497, CH-8063, Zürich, Switzerland

    Christoph A. Meier M.D.

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Correspondence to Michel Procopiou .

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  1. Chairman, Department of Surgery, University Hospital Basel, Spitalstr. 21, Basel, 4031, Switzerland

    Daniel Oertli

  2. Yale-New Haven Hospital, Department of Surgery, Yale University School of Medicine, Cedar Street 330FMB 102, New Haven, CT, 06520-8062, USA

    Robert Udelsman

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Procopiou, M., Meier, C.A. (2012). Evaluation of Thyroid Nodules. In: Oertli, D., Udelsman, R. (eds) Surgery of the Thyroid and Parathyroid Glands. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23459-0_5

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