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. 1997 Sep;73(863):560–564. doi: 10.1136/pgmj.73.863.560

Management options for solitary thyroid nodules in an endemic goitrous area.

A K Sarda 1, A Gupta 1, P K Jain 1, S Prasad 1
PMCID: PMC2431457  PMID: 9373596

Abstract

An analysis of management of 546 cases of solitary thyroid nodules in an endemic area is presented. None of the evaluating procedures could effectively isolate benign from malignant disease. Of 508 cases considered clinically to be benign, 42 harboured malignancy on histological examination whereas of the 38 cases suspected clinically to be malignant, 21 were histologically benign. 131I-Thyroid scanning also lacked sensitivity in identifying malignant nodules since the prevalence of malignancy in cases which were 'cold' (44/316) was not significantly different from that amongst the 'uniform' cases (15/142). Fine-needle aspiration cytology, although the most sensitive and specific evaluating modality, did not decrease the number of operations for solitary thyroid nodules nor did it increase the incidence of malignancy amongst the operated cases, because of its limitations in differentiating benign from malignant follicular neoplasms. The conditions under which surgery was advocated are described.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ashcraft M. W., Van Herle A. J. Management of thyroid nodules. II: Scanning techniques, thyroid suppressive therapy, and fine needle aspiration. Head Neck Surg. 1981 Mar-Apr;3(4):297–322. doi: 10.1002/hed.2890030406. [DOI] [PubMed] [Google Scholar]
  2. Blum M., Shenkman L., Hollander C. S. The autonomous nodule of the thyroid: correlation of patient age, nodule size and functional status. Am J Med Sci. 1975 Jan-Feb;269(1):43–50. doi: 10.1097/00000441-197501000-00006. [DOI] [PubMed] [Google Scholar]
  3. Burch H. B. Evaluation and management of the solid thyroid nodule. Endocrinol Metab Clin North Am. 1995 Dec;24(4):663–710. [PubMed] [Google Scholar]
  4. Bäckdahl M., Wallin G., Löwhagen T., Auer G., Granberg P. O. Fine-needle biopsy cytology and DNA analysis. Their place in the evaluation and treatment of patients with thyroid neoplasms. Surg Clin North Am. 1987 Apr;67(2):197–211. doi: 10.1016/s0039-6109(16)44179-4. [DOI] [PubMed] [Google Scholar]
  5. Clark O. H. TSH suppression in the management of thyroid nodules and thyroid cancer. World J Surg. 1981 Jan;5(1):39–47. doi: 10.1007/BF01657832. [DOI] [PubMed] [Google Scholar]
  6. Frable W. J. The treatment of thyroid cancer. The role of fine-needle aspiration cytology. Arch Otolaryngol Head Neck Surg. 1986 Nov;112(11):1200–1203. doi: 10.1001/archotol.1986.03780110076011. [DOI] [PubMed] [Google Scholar]
  7. Gharib H., Goellner J. R. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993 Feb 15;118(4):282–289. doi: 10.7326/0003-4819-118-4-199302150-00007. [DOI] [PubMed] [Google Scholar]
  8. Hamburger J. I. Evolution of toxicity in solitary nontoxic autonomously functioning thyroid nodules. J Clin Endocrinol Metab. 1980 Jun;50(6):1089–1093. doi: 10.1210/jcem-50-6-1089. [DOI] [PubMed] [Google Scholar]
  9. Hill L. D., Beebe H. G., Hipp R., Jones H. W. Proceedings: Thyroid suppression. Arch Surg. 1974 Apr;108(4):403–405. doi: 10.1001/archsurg.1974.01350280011003. [DOI] [PubMed] [Google Scholar]
  10. Jossart G. H., Clark O. H. Well-differentiated thyroid cancer. Curr Probl Surg. 1994 Dec;31(12):933–1012. doi: 10.1016/0011-3840(94)90063-9. [DOI] [PubMed] [Google Scholar]
  11. Lennquist S. The thyroid nodule. Diagnosis and surgical treatment. Surg Clin North Am. 1987 Apr;67(2):213–232. doi: 10.1016/s0039-6109(16)44180-0. [DOI] [PubMed] [Google Scholar]
  12. Oommen R., Walter N. M., Tulasi N. R. Scintigraphic diagnosis of thyroid cancer. Correlation of thyroid scintigraphy and histopathology. Acta Radiol. 1994 May;35(3):222–225. [PubMed] [Google Scholar]
  13. Rojeski M. T., Gharib H. Nodular thyroid disease. Evaluation and management. N Engl J Med. 1985 Aug 15;313(7):428–436. doi: 10.1056/NEJM198508153130707. [DOI] [PubMed] [Google Scholar]
  14. Sarda A. K., Bal S., Dutta Gupta S., Kapur M. M. Diagnosis and treatment of cystic disease of the thyroid by aspiration. Surgery. 1988 May;103(5):593–596. [PubMed] [Google Scholar]
  15. Sarda A. K., Kapur M. M. Thyroid carcinoma. A report of 206 cases from an area with endemic goitre. Acta Oncol. 1990;29(7):863–867. doi: 10.3109/02841869009096380. [DOI] [PubMed] [Google Scholar]
  16. Sarda A. K., Padhy A. K., Sharma A., Kapur M. M. Autonomously functioning thyroid nodule. South Med J. 1989 Feb;82(2):206–209. doi: 10.1097/00007611-198902000-00015. [DOI] [PubMed] [Google Scholar]
  17. Silverman J. F., West R. L., Larkin E. W., Park H. K., Finley J. L., Swanson M. S., Fore W. W. The role of fine-needle aspiration biopsy in the rapid diagnosis and management of thyroid neoplasm. Cancer. 1986 Mar 15;57(6):1164–1170. doi: 10.1002/1097-0142(19860315)57:6<1164::aid-cncr2820570617>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]

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