Thyroid nodular disease is defined as the enlargement of the thyroid gland that is palpable clinically. It is estimated that the lifetime risk of developing a nodule is between 5-10%. However, with the widespread use of ultrasound and a study of autopsy material, it is found that > 50% of the population develop thyroid nodules during their lifetime, most of which are small and most of which lack clinical significance. Nevertheless, because few of them harbor malignancy (5-17% of solitary nodules), the diagnostic approach to exclude cancer is a frequent and important clinical problem.
| Thyroid nodules |
| Clinical factors predisposing to the presence of malignancy |
| Family history |
| Age < 20 or > 60 years |
| Gender male > female |
| Neck radiation |
| Rapid growth |
| Tumor growth under suppression therapy |
| Pain |
| Dysphagia - hoarse voice - Dyspnea |
| Clinical hypothyroidism |
| Suspicious ultrasound features-ACR-TIRADS scale |
| Cervical lymph node enlargement |
The first information obtained from the history and physical examination is useful and may suggest the presence of malignancy. Familial goiter can indicate a benign lesion except when medullary thyroid carcinoma is reported alone or in combination with pheochromocytoma in the context of multiple endocrine neoplasia type II. Finally, there are families in which several members have papillary or follicular thyroid carcinoma.
GRADUATE COURSES IN ENDOCRINOLOGY AND DIABETES- DEPARTMENT OF ENDOCRINOLOGY DIABETES AND METABOLISM OF EVANGELISMOS GENERAL HOSPITAL OF ATHENS- 2004
