scholarly journals MULTINODULAR GOITER;

2013 ◽  
Vol 20 (06) ◽  
pp. 1035-1041
Author(s):  
ZULFIQAR ALI BHATTI, ◽  
JAVED AHMED PHULPOTO, ◽  
NOOR AHMED SHAIKH,
Keyword(s):  
Multinodular Goiter ◽  
Prospective Observational Study ◽  
Thyroid Nodules ◽  
Significant Risk ◽  
Nodular Goiter ◽  
University Hospital ◽  
Risk Of Malignancy ◽  
The Common ◽  
Thyroid Profile ◽  
Surgical Unit

Objective: The object of this study was to determine the frequency and type of thyroid carcinoma in Multi nodular goiter(MNG) after surgical resection on histopathological basis. Introduction: Multi nodular goiter (MNG) is one of the common presentationsof various thyroid diseases. Thyroid nodules have been reported to be found in 4% to 7% of the population on neck palpation. Although incomparison to solitary nodule, the risk of malignancy in MNG is low but certain studies are showing significant risk. Material andmethods: This prospective, observational study was carried out in the surgical unit I of Ghulam Mohammad Mahar Medical collegehospital sukkur from 2007 to 2012. 94 cases with clinical diagnosis of MNG were analyzed during this period. All the patients wereadmitted through opd with routine investigations plus investigations specific to thyroid including thyroid profile, thyroid scan, FNAC ofdominant nodule before being subjected to surgery. All FNACs were carried out at agha khan university hospital Karachi. Histopathologyof operated specimen was the main criteria for malignancy. Results: Among the 94 cases which were included in this study, 9 (9.5%)cases containing foci of malignancy. Incidence of malignancy commonly occurs in females, papillary carcinoma is being the commonestentity. Conclusions: The incidence of malignancy in MNG in this study is 9.5% that is quite high. So people should be educated andencouraged to attend the thyroid clinics for proper evaluation and early diagnosis of Malignancy.

scholarly journals Predictors of Malignancy in Patients With Thyroid Nodule(s)

2017 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Islam Alatiar ◽  
Hassam Elfol ◽  
Tarek Rageh
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Surgery ◽  
Large Scale ◽  
Thyroid Nodules ◽  
Nodular Goiter ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
University Hospital ◽  
Fine Needle ◽  
Risk Of Malignancy

Purpose: To detect the predictors of malignancy in patients with thyroid nodule(s). Background: Thyroid nodules are common surgical problem with 5-10% risk of malignancy. Thyroid surgery is a major operation with many complications. So, it is important to search for the predictors of malignancy in thyroid nodules to spare more benign lesions from surgery. Patients and methods: This prospective study includes 150 patients with thyroid nodule(s), all were admitted for thyroidectomy at Menoufia University Hospital. Demographic and clinical data, ultrasound, fine needle aspiration reports and final histopathology were recorded and analyzed. Patients with previous thyroid surgery or previous neck biopsy were excluded. Results: About 20% of the studied population proved to have malignant nodules on final histopathology reports. Out of 150 cases, there were 83 with multi-nodular goiter and 67 with solitary thyroid nodules. There were higher incidence of malignancy in male patients. The incidence also was higher in solitary nodules than in multinodular goiter. There were statistically significant ultrasound features differences such as; micro-calcifications, ill-defined edges, solid consistency, hypo-echoic pattern, intra-nodular vascularity and size below 2cm. Regarding fine needle biopsy, there were a significant increase in incidence of malignancy from Bethesda(II) – Bethesda(VI) with highest incidence in Bethesda(VI). Conclusion: Predictors of malignancy detected were; male gender, solitary nodules, micro-calcifications, hypo-echoic pattern, ill-defined edges, intra-nodular vascularity, solid nodules, size below 2 cm and Bethesda VI. Large scale multi center studies are needed for more solid statistical result.

scholarly journals Papillary thyroid cancer in an adolescent with a toxic single nodular goiter

2017 ◽  
Vol 63 (2) ◽  
pp. 114-116 ◽  
Author(s):  
Olga S. Rogova ◽  
Goar F. Okminyan ◽  
Lubov N. Samsonova ◽  
Elena V. Kiseleva ◽  
Oleg Yu. Latyshev ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodule ◽  
Papillary Thyroid Cancer ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Risk Of Malignancy ◽  
Functional Autonomy

The rate of nodular goiter in children ranges from 0.05 to 5.1%; in this case, the risk of thyroid cancer in childhood amounts to 3―70% of all cases of thyroid pathology. Therefore, the main issue is the differential diagnosis of a nosological variant of a thyroid nodule, which defines the optimal therapeutic tactics for a particular patient. The risk of malignancy is traditionally believed to be low in the case of decompensated functional autonomy of a thyroid nodule; therefore, the need for fine needle aspiration biopsy (FNAB) followed by cytomorphological analysis of the aspirate is avoided in most cases. The presented clinical case demonstrates papillary cancer in an adolescent with a toxic single nodular goiter. A thyroid ultrasound examination revealed a nodular lesion in the boy. An increase in the thyroid size and thyrotoxicosis manifestation occurred 3 years later. A cytomorphological study identified follicular neoplasia; scintigraphy revealed a hot nodule. Surgical treatment was planned. Antithyroid therapy was prescribed to prepare for surgery. After compensation of thyrotoxicosis, hemithyroidectomy was performed. A histological examination diagnosed papillary thyroid cancer, which required repeated thyroidectomy followed by radioiodine I131 ablation. The postoperative period was uneventful; the patient well tolerated suppressive levothyroxine therapy. Therefore, the presence of a toxic single nodular goiter does not exclude thyroid cancer, which defines the need to discuss the indications for FNAB of thyroid nodules in children.

Value of the Ultrasound Elastography in the Diagnosis of Thyroid Nodules

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T I A Ouf ◽  
H H Hanna ◽  
A M B Ghaly
Keyword(s):  
Predictive Value ◽  
Thyroid Nodules ◽  
Nodular Goiter ◽  
Ultrasound Elastography ◽  
University Hospital ◽  
Common Occurrence ◽  
Ethical Committee Approval ◽  
High Negative Predictive Value ◽  
High Positive Predictive Value

Abstract Background Thyroid disease is of common occurrence, especially in iodine deficient areas. Thyroid nodules have been reported in as many as 50% of the population, at autopsy. They may be discovered in up to 41% of the patients at ultrasonography (US). Aim of the Work The aim of this study is to evaluate the value of Ultrasound- Elastography in the Diagnosis of thyroid nodules for reducing the number of unnecessary Thyroidectomises which add burden to the patient and community, consequently the complications of this surgery will be reduced. Patients and Methods This prospective cohort study was conducted at El Demerdash, Ain Shams University Hospital on Fifty (50) patients with the diagnosis of multi-nodular goiter, who were treated by total thyroidectomy between November 2016 and November 2018 with minimum follow up of one month postoperatively. An informed consent was taken from all patients who accepted to participate in our study after ethical committee approval. Results Elastography has 100% sensitivity and 95.5% specificity as it suspected malignancy (positive suspecting findings) in 8 patients; six of them were proved to be malignant and two of them were benign by histopathology accounting for high positive predictive value (75%) and it suspected benignity (negative suspecting findings) in 42 patients; all of them were perfectly correlated with the histopathology accounting for high negative predictive value (100%). These results showed nearly the same values of the Elastography in the previous studies had been done regarding this concern. Conclusion Conclusively, In the future, FNAC perhaps will not be used for the diagnosis of malignancy in patients presented with multi-nodular goitres who were diagnosed as suspicious of malignancy by Sono-elastography.

scholarly journals Multinodular Goiter: A Study of Malignancy Risk in Nondominant Nodules

2017 ◽  
Vol 96 (8) ◽  
pp. 336-340
Author(s):  
Jenica Su-ern Yong ◽  
Kwok Seng Loh ◽  
Bengt Fredrik Petersson ◽  
Mark Thong
Keyword(s):  
Lower Risk ◽  
Multinodular Goiter ◽  
Thyroid Nodules ◽  
Recent Literature ◽  
Asian Population ◽  
Neck Surgery ◽  
Histologic Type ◽  
Risk Of Malignancy ◽  
Study Population ◽  
Sizable Proportion

The long-standing belief that multinodular goiters are associated with a lower risk of developing into carcinoma has been challenged by the results of some recent studies. In addition, we have noticed in our practice that a sizable proportion of cancers have been arising from nondominant nodules. We performed a retrospective study of 223 cases to determine (1) the incidence of carcinoma in multinodular goiters that required surgical management in our local, predominantly Asian population and (2) the incidence of carcinoma arising from nondominant nodules. We reviewed the records of all patients with a multinodular goiter who had undergone a thyroidectomy over a period of more than 10 years in our Department of Otolaryngology–Head and Neck Surgery. We examined the histopathology reports for (1) the presence of carcinoma, (2) whether the carcinoma was isolated/unifocal or multifocal, (3) the histologic type of cancer, and (4) whether the isolated/unifocal cancers arose from the dominant or nondominant nodule. Our study population was made up of 47 males and 176 females, aged 15 to 90 years (mean: 53). We found that the incidence of malignancy in surgically treated multinodular goiters was 14.3% (32 of 223 patients). Of the 32 malignancies, 18 (56.3%) were isolated/unifocal and 14 (43.8%) were multifocal. In the isolated/unifocal group, 9 malignancies (50.0%) arose from nondominant nodules and 8 (44.4%) from dominant nodules; in the remaining case, the nodule of origin could not be determined. Our findings corroborate those in the recent literature in that the risk of malignancy associated with multinodular goiters is comparable to that of single thyroid nodules. We recommend that physicians be equally vigilant when monitoring dominant and nondominant nodules.

TO EVALUATE ROLE OF MORPHOLOGICAL CRITERIA ON USG AND ELASTOGRAPHY IN DIFFERENTIATING BENIGN AND MALIGNANT THYROID LESION

2021 ◽  
pp. 40-42
Author(s):  
Ashok Kumar Verma ◽  
Rakesh Kumar Verma ◽  
Rashmi Rashmi ◽  
Neha Kumari
Keyword(s):  
Gold Standard ◽  
Prospective Observational Study ◽  
Thyroid Nodules ◽  
Nodular Goiter ◽  
Thyroid Lesion ◽  
Diagnostic Reliability ◽  
Medical College ◽  
Morphological Criteria ◽  
Autopsy Data

Introduction: Thyroid nodules are common and are commonly benign. The reported prevalence of nodular thyroid disease depends on the population studied and the methods used to detect nodules. Numerous studies suggest a prevalence of 2-6% with palpation, 19-35% with ultrasound, and 8-65% in autopsy data. Aims and objectives: To evaluate diagnostic reliability of ultrasound morphological criteria (ACR-TIRADS system) and elastographyin differentiating benign from malignant thyroid nodules in patients using cytopathology or histopathology as gold standard. Materials and methods: Prospective observational study, Patients visiting LLR (Hallet) Hospital with clinically suspicious thyroid nodule, LLR (Hallet) Hospital, GSVM Medical College, Jan 2019 to Oct 2020. Result: Showing distribution of composition of nodules in our study subjects Maximum nodules have mixed solid cystic composition . Showing distribution of echogenicity of nodules in our study subjects. Maximum nodules in our study have to hyperechoic echogenicity. Showing distribution of margin of nodules in our study subjects. Maximum nodules in our study have ill dened margin. Conclusion: In conclusion, no single investigation was found to be 100% sensitive or specic in diagnosing malignancy in nodular goiter but a good clinical, FNAC and USG examinations are complimentary to each other in predicting malignancy and avoid unnecessary or inadequate surgery.

scholarly journals Dependence of Thyroid Sonographic Markers of Malignancy and Its Influence on the Diagnostic Value of Sonographic Findings

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Kosma Woliński ◽  
Adam Stangierski ◽  
Ewelina Szczepanek-Parulska ◽  
Edyta Gurgul ◽  
Marek Ruchała
Keyword(s):  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Medical Condition ◽  
Nodular Goiter ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Independent Variables ◽  
Risk Of Malignancy ◽  
Selection Of

Introduction. Thyroid nodules constitute frequent medical condition. Ultrasonographic (US) examination remains the basis in the diagnostics of nodular goiter and selection of the suspected ones requiring fine-needle aspiration biopsy (FNAB). The aim of this study was to evaluate if the features so far considered to be US malignancy markers are dependent or independent variables and to check if these data are clinically relevant.Materials and Methods. Patients with diagnosed thyroid nodular goiter admitted for thyroidectomy, irrespectively of the indications for surgery, were involved. The following parameters were assessed: echogenicity, the presence of calcifications, presence of halo, shape, margins, structure (solid, partially or pure cystic), and elasticity of the nodules (assessed quantitatively).Results. 122 consecutive patients with 393 thyroid nodules were included. There were significant associations between halo absence and irregular borders, micro- and macrocalcifications, taller-than-wide feature and macrocalcifications, irregular margins and macrocalcifications, and also decreased elasticity of nodules and several attributes (partially cystic character, micro- and macrocalcifications).Conclusions. Not only diagnostic value of particular sonographic features but also data about cooccurrence and associations between them are clinically relevant. Although most of these features turned out to be independent, omitting significant association can lead to incorrect assessment of the risk of malignancy.

scholarly journals What Happens in a 5-Year Follow-Up of Benign Thyroid Nodules

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Roberto Negro
Keyword(s):  
Multinodular Goiter ◽  
Thyroid Nodules ◽  
Nodular Goiter ◽  
Optimal Time ◽  
Interval Time ◽  
Significant Events ◽  
Annual Visit ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

To determine an optimal time for follow-up of benign thyroid nodules, we retrospectively evaluated 249 euthyroid patients with uni-multinodular goiter, who underwent annual visit, and significant events that occurred in 5 years’ time were registered. A significant event (appearance of new nodule, increase of nodule diameter >50%, appearance of compressive symptoms, thyroidectomy, repetition of FNA on the same nodule, and execution of FNA on new nodule) occurred in 26.1% of patients, with more than one event occurring in the same patient in 27.7% of cases. The majority of events (71.9%) were observed at 24- and 36-month follow-up visit. These results suggest that a patient diagnosed with benign nodular goiter may be safely followed-up at a 2-3-year interval time.

scholarly journals Should Mode of Presentation Influence Interpretation of Thyroid Nodule Ultrasounds?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A870-A871
Author(s):  
Lisa Stevens ◽  
Peter M Davoren
Keyword(s):  
Medical Records ◽  
Thyroid Nodules ◽  
Final Diagnosis ◽  
Gold Coast ◽  
University Hospital ◽  
Risk Of Malignancy ◽  
Neck Lump ◽  
Work Up ◽  
Patient Presentation ◽  
Unnecessary Testing

Abstract Background: The American College of Radiology (ACR) TI-RADS is a standardized scoring system for thyroid ultrasound reports providing recommendations on the need for fine needle aspirations (FNAs) independent of patient presentation. Aim: The aim of this audit was to determine if the initial presentation of the patient should be considered during the work-up of thyroid nodules. Methods: Data was collected from electronic medical records on 133 patients who underwent thyroid FNAs (165 FNAs in total) and 98 patients who had thyroid surgery for the management of thyroid nodules at Gold Coast University Hospital from Jan 1st 2019 – Dec 31st 2019. Patient presentation, adequacy of the ultrasound report and FNA results were recorded. These results were aligned with final diagnosis after surgery. Results: 98 patients underwent surgery and 29 (29.6%) were found to have malignant nodules, including 12 (12.2%) with microcarcinomas. Of the 29 malignancies, 16 patients presented with a palpable neck lump. Conclusions: Our data suggests a palpable neck lump is a significant factor in determining the risk of malignancy. It may be possible to adjust the current TI-RADS algorithm used to interpret thyroid ultrasounds to include patient presentation. This would reduce unnecessary testing and burden on the healthcare system.

scholarly journals Assessment of Nondiagnostic Ultrasound-Guided Fine Needle Aspirations of Thyroid Nodules

2002 ◽  
Vol 87 (11) ◽  
pp. 4924-4927 ◽  
Author(s):  
Erik K. Alexander ◽  
Jenny P. Heering ◽  
Carol B. Benson ◽  
Mary C. Frates ◽  
Peter M. Doubilet ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Significant Risk ◽  
Needle Aspiration ◽  
Multivariable Model ◽  
Ultrasound Guided ◽  
Significant Independent Predictor ◽  
Fine Needle ◽  
Risk Of Malignancy

Abstract Thyroid nodules are common. Evaluation of patients with thyroid nodules typically includes fine needle aspiration biopsy (FNA), an approach that has proven to be accurate for the detection of thyroid cancer. Although the majority of biopsies are adequate for a cytological diagnosis, up to 20% will be insufficient or nondiagnostic. Current opinion suggests that such aspirates should be repeated, although no systematic study has investigated the usefulness of this approach, especially when ultrasound guidance is used to direct the initial FNA. We sought to define the predictors and optimal follow-up strategy for initial nondiagnostic ultrasound-guided FNAs of thyroid nodules. Data were collected for all patients at the Brigham and Women’s Hospital Thyroid Nodule Clinic between 1995–2000 who underwent ultrasound-guided FNA of a thyroid nodule. All patients with nondiagnostic cytology were advised to return for a repeat ultrasound-guided FNA. Patient age, gender, nodule size, cystic content, solitary vs. multinodular thyroid, and nodule location were documented and evaluated as possible predictors of a nondiagnostic biopsy in a multivariable model. The rate of diagnostic cytology obtained on repeat ultrasound-guided FNA was calculated. A total of 1128 patients with 1458 nodules were biopsied over a 6-yr period. A total of 1269 aspirations (950 patients) were diagnostic, and 189 (178 patients) were nondiagnostic. The cystic content of each nodule was the only significant independent predictor of nondiagnostic cytology (P < 0.001). The fraction of specimens with initial nondiagnostic cytology increased with greater cystic content (P < 0.001 for trend). A diagnostic ultrasound-guided FNA was obtained on the first repeat biopsy in 63% of nodules and was inversely related to increasing cystic content of each nodule (P = 0.03). One hundred and nineteen patients with 127 nodules returned for follow-up as advised, and malignancy was documented in 5%. Despite ultrasound-guided FNA, there remains a significant risk of initial nondiagnostic cytology, largely predicted by the cystic content of each nodule. Repeat aspiration is often successful and should be the standard approach to such nodules, given their risk of malignancy.

scholarly journals SUN-LB24 Clinical Performance of Multiplatform Mutation Panel MicroRNA Risk Classifier in Indeterminate Thyroid Nodules

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
J Woody Sistrunk ◽  
Alexander Shifrin ◽  
Marc Frager ◽  
Ricardo H Bardales ◽  
Johnson Thomas ◽  
...  
Keyword(s):  
High Risk ◽  
Patient Outcomes ◽  
Thyroid Nodules ◽  
Clinical Performance ◽  
Significant Risk ◽  
Fine Needle Aspirates ◽  
Clinical Risk ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Risk Of Malignancy

Abstract Introduction: We evaluated the clinical performance of an expanded mutation panel in combination with microRNA classification (MPTX) for the management of indeterminate thyroid nodules. Methods: MPTX included testing of fine needle aspirates with a combination of ThyGeNEXT® mutation panel for strong and weak driver oncogenic changes and ThyraMIR® microRNA risk classifier. MPTX test status (positive or negative) and MPTX clinical risk classifications (low, moderate, or high risk) were determined blind to patient outcomes. Surgical pathology and clinical follow-up records of patients from multiple centers were used to determine patient outcomes. MPTX performance was assessed by Kaplan Meier analysis for cancer-free survival of patients, with risk of malignancy determined by hazard ratios (HR). Results: Our study included 140 patients with AUS/FLUS or FN/SFN nodules, of which 13% had malignancy. MPTX negative test status and MPTX low risk results conferred a high probability (94%) that patients would remain cancer free. MPTX positive test status (HR 11.2, P<0.001) and MPTX moderate risk results (HR 8.5, P=0.001) were significant risk factors for malignancy, each conferring a 53% probability of malignancy. MPTX high risk results elevated risk of malignancy even more so, conferring a 70% probability of malignancy (HR 38.5, P<0.001). Conclusions: MPTX test status accurately stratifies patients for risk of malignancy. Further classification using MPTX clinical risk categories enhances utility by accurately identifying patients at low, moderate, or high risk of malignancy at the low rate of malignancy encountered when clinically managing patients with indeterminate thyroid nodules.

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