ทบทวนวรรณกรรม Thomas V.McCaffrey, MD, PhD “ Evaluation of the Thyroid Nodule ” Clinical detectable thyroid nodules occur in up to 4% of the population in the United States. Adiffusely multinodular gland is usually benign but do not assure that the lesions are benign. Although multinodularity reduces the possibility of malignancy, malignancy can occur in the multinodular gland.
Professor Joong-Wha Koh, MD “ Practical Approach to the Thyroid Nodules ” Incidence of thyroid malignancy : 1% of all cancers. Multiple nodules : most common in nature usually end stage of benign disease, consisting of areas of colloid storage-degeneration, hyperplasia, cyst formation, even inflammation, malignancy in 1-2 % Single nodular : more likely neoplasm, malignancy incidence higher than multiple thyroid nodules, malignancy in 5-20%
New York Thyroid Center Characteristics of Thyroid nodule is cancerous include # a single nodule in a thyroid gland # a hard nodule # enlarged lymph nodes in the neck region # no decreasein nodule size after thyroid hormone medication or no response to thyroid suppression
Endocrineweb.com Thyroid function tests rarely help a differential diagnosis Fine-needle aspiration is the only non-surgical method which can differential malignant and benign nodules in most, but not all cases
Archives International Medicine Special Article-October 28, 1996 Treatment Guidelines for Patients with Thyroid Nodules and Well-differentiated Thyroid Cancer Between 4% and 7% of individauls in the United States have palpablthyroid nodules.Thyroid nodules are more common in women and increase in frequency with age.Fewer than 10% of solitary nodules are malignancy. Multinodularity, especially if thenodules all have the same consistency, is consistent with a benign multiple thyroid nodules.A nodule or mass that is dominant in size or has a different consistency than other nodules within the gland should be evaluated by employing the same criteria as those outlined for single nodules
Clinical Oncology 2nd edition 2000 Abeloff,Armitage,Lichter,Niederhu ber Risk factors for malignancy in nodular thyroid Low risk High risk Sex male 4 Multiple mass2 female2Solitary mass 3 FNAnegative2Complete resolution to positive5 thyroid suppression 1