8 Thomas V.McCaffrey , MD , PhD “Evaluation of the Thyroid Nodule” ทบทวนวรรณกรรมThomas 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.
9 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 benigndisease , consisting of areas of colloid storage-degeneration , hyperplasia ,cyst formation , even inflammation , malignancy in 1-2 %Single nodular : more likely neoplasm , malignancy incidence higher thanmultiple thyroid nodules , malignancy in 5-20%
11 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 orno response to thyroid suppression
12 Endocrineweb.comThyroid function tests rarely help a differential diagnosisFine-needle aspiration is the only non-surgical method which candifferential malignant and benign nodules in most , but not all cases
13 Archives International Medicine Special Article-October 28 , 1996 Treatment Guidelines for Patients with Thyroid Nodules andWell-differentiated Thyroid CancerBetween 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
14 Clinical Oncology 2nd edition 2000 Abeloff ,Armitage,Lichter,NiederhuberRisk factors for malignancy in nodular thyroidLow risk High riskSex male Multiple mass 2female 2 Solitary mass 3FNA negative 2 Complete resolution topositive thyroid suppression 1