Table 4.
Additional cases with scintigraphic evidence suggestive of an autonomous thyroid nodule without documented hyperthyroidism (or already on levothyroxine replacement therapy) discovered to harbor thyroid carcinoma on pathologic review
# | Age | Sex | Tumor growth (cm) | High risk historya | Suspicious U/Sb | Nodule sizec (cm) | Tumor sized (cm) | TFTse | Toxic sx? | Compression sx? | Scan type | FNA | Surgical path | Reference (1st author) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 |
51 |
F |
2.7→5.3 in 2yrs |
- |
- |
5.3 |
5 |
on LT4 |
- |
+ |
Tc,131I |
Follicular neoplasm |
Poor diff cancer |
Low [61] |
2 |
44 |
F |
|
- |
|
3.5 |
3.7 |
nl |
- |
- →+ |
Tc |
Benign |
FTC |
Schneider [62] |
3 |
47 |
M |
|
|
|
1.4 |
1 |
nl |
- |
|
123I |
|
PTC |
Bourasseau [41] |
4 |
34 |
F |
|
|
|
1 |
1 |
nl |
- |
|
123I |
“Cancer” |
PTC |
Bourasseau [41] |
5 |
37 |
F |
|
|
|
1.5 |
1.5 |
nl |
- |
|
123I |
Nondiagnostic |
FTC |
Bourasseau [41] |
6 |
39 |
M |
|
|
|
3 |
|
nl |
|
|
123I |
|
FVPTC |
Mizukami [46] |
7 |
69 |
F |
|
Prior PTC |
|
4 |
3.3 |
on LT4 |
+ |
- |
131I |
|
Hurthle |
Caplan [63] |
8 |
39 |
M |
|
|
HE,PD,Cal |
|
1.5 |
nl |
- |
- |
123I |
|
PTC |
Michigishi [64] |
9 |
65 |
F |
|
|
|
4.3 |
|
nl |
|
|
Tc |
|
PTC |
Ikekubo [48] |
10 |
37 |
F |
|
|
|
2.5 |
|
nl |
|
|
Tc |
|
PTC |
Ikekubo [48] |
11 |
39 |
F |
|
|
|
3.5 |
|
nl |
|
|
Tc |
|
PTC |
Ikekubo [48] |
12 |
38 |
F |
|
|
|
4.5 |
|
nl |
|
|
Tc |
|
PTC |
Ikekubo [48] |
13 |
35 |
F |
|
- |
|
1 |
0.4 |
nl |
- |
- |
123I |
|
PTC |
Rubenfeld [65] |
14 |
51 |
M |
|
XRT |
|
“large” |
|
on LT4 |
- |
|
123I |
|
FTC |
Nagai [50] |
15 |
19 |
F |
4x2→4x3 in 1 yr |
|
|
4 |
4 |
nl |
- |
- |
131I |
|
PTC/FTC |
Abdel-Razzak [66] |
16 |
15 |
F |
|
- |
|
|
|
nl |
- |
- |
Tc |
|
PTC |
Scott [67] |
17 |
27 |
F |
|
|
- |
4 |
2.3 |
nl |
+ |
- |
131I |
|
PTC |
Fujimoto [68] |
18 |
21 |
F |
|
|
|
3 |
1 |
NA |
+ |
+ |
131I |
|
PTC |
Becker [69] |
19 |
23 |
F |
|
|
|
1.5 |
1 |
NA |
- |
- |
131I |
|
PTC |
Becker [69] |
20 |
28 |
M |
|
|
|
4.5 |
0.5 |
NA |
+ |
- |
131I |
|
PTC |
Molnar [70] |
21 |
54 |
M |
|
|
|
8.5 |
|
NA |
|
|
131I |
|
FTC |
Als [58] |
22 |
62 |
F |
|
|
|
|
|
NA |
|
|
131I |
|
PTC |
Als [58] |
23 |
61 |
M |
|
|
|
|
|
NA |
|
|
131I |
|
FTC |
Als [58] |
24 |
50 |
M |
|
|
|
10 |
|
NA |
|
|
131I |
|
FTC |
Als [58] |
25 |
65 |
F |
|
|
|
5 |
|
NA |
|
|
131I |
|
FTC |
Als [58] |
26 |
55 |
F |
|
|
|
5.5 |
|
NA |
|
|
131I |
|
FTC |
Als [58] |
27 |
66 |
F |
|
|
Cal |
|
|
nl |
- |
+ |
Tc,131I |
Colloid goiter |
PTC |
Bitterman [33] |
77 | 35 | M | - | 5.4 | 0.5 | Highf | Hurthle | Zanella [17] |
Abbreviations: + = yes; - = no; Cal = microcalcifications; FNA = fine needle aspiration; FTC = follicular thyroid carcinoma; FVPTC = follicular variant of papillary thyroid carcinoma; HE = hypoechoic; 123I = Iodine-123; 131I = Iodine-131; IV = internal vascularity; LT4 = levothyroxine; NA = not available; nl = normal; PD = poorly demarcated; PTC = papillary thyroid carcinoma; sx = symptoms; SHT = subclinical hyperthyroidism; fT3 = free triiodothyronine; fT4 = free thyroxine; TT3 = total triiodothyronine; TT4 = total thyroxine; 99mTc = technetium-99m-pertechnetate; TFTs = thyroid function testing; U/S = ultrasound; XRT = external beam radiotherapy.
a High-risk history: ionizing radiation exposure as child/adolescent, prior personal history of thyroid cancer, and family history of thyroid cancer in one or more 1st-degree relatives; as per Cooper et al. [6].
b Suspicious ultrasound: hypoechoic, microcalcifications, increased nodular vascularity, poorly demarcated; as per Cooper et al. [6].
c Nodule size: The largest diameter of the thyroid nodule measured by ultrasonography, or if ultrasound not available, then by palpation.
d Tumor size: The largest diameter of the thyroid nodule measured grossly after surgical resection.
e TFTs: Indicates which thyroid hormone values (total T3, total T4, free T3, and/or free T4) were elevated at time of presentation, as opposed to SHT or euthyroidism. Of note, for many of these cases, no mention of one or more of these four standard thyroid hormone values was included.
f High: Indicates that the patient was biochemically hyperthyroid, though specific thyroid hormone levels were not given.