Abstract
BackgroundThyroid nodule diagnosis has become increasingly frequent. Defining optimum surveillance intervals for patients with unsuspicious thyroid nodules remains a challenge. This was a single centre cohort study in which patients diagnosed with unsuspicious thyroid nodules in whom no treatment was indicated were invited for re-evaluation 5 years after the diagnosis. The primary end point of the study was to estimate the change in nodule size with thyroid ultrasound (US) and the secondary end point was to assess the need for clinical management 5 years after the diagnosis.Patients and methodsBaseline patient parameters and ultrasound characteristics of the nodules were retrospectively collected. At follow-up, thyroid ultrasound was performed.ResultsA hundred and eighteen (107 women / 11 men, aged 56.8 ± 13.4 years) patients were included in the study having 203 nodules at baseline, with mean largest nodule diameter 10.5 ± 7.4 mm. After 5 years, 58 (28.6%) nodules significantly increased in size, 27 (13.3%) decreased, and for 104 (51.2%) of nodules, no change in size was noted. Fourteen (6.9%) nodules disappeared. Additional 26 new nodules (mean largest diameter 7.7 ± 5.0 mm) in 16 patients were identified at follow-up. Regarding the clinical outcome, no new thyroid cancers were found. For 107 (90.7%) patients no further management was indicated. Five (4.2%) patients were referred to thyroidectomy because of the growth of the nodules. Two (1.7%) patients were treated for hyperthyroidism. Four (3.4%) patients did not complete the study.ConclusionsWe report a single centre experience of the natural history of unsuspicious thyroid nodules. Our results showed that 71.4% of such nodules remained stable in size, decreased or even disappeared and that the vast majority of the patients remained clinically stable with no need for treatment 5 years after the diagnosis.
Highlights
Thyroid nodules are discrete lesions within the thyroid gland that are morphologically distinct from the surrounding thyroid parenchyma.[1]
The purpose of our study was to establish a natural history of thyroid nodules in a cohort of euthyroid patients diagnosed with unsuspicious thyroid nodules
One hundred and eighteen patients were included in the study, with 203 thyroid nodules identified at baseline
Summary
Thyroid nodules are discrete lesions within the thyroid gland that are morphologically distinct from the surrounding thyroid parenchyma.[1]. The initial evaluation of patients with thyroid nodules consists of careful clinical, imaging and laboratory assessment, often aided by US-guided fine needle aspiration biopsy (FNAB). It should identify a small subgroup of nodules that either harbour thyroid cancer Since the knowledge of the natural history of thyroid nodules is incomplete, defining optimum surveillance intervals still remains a challenge with goals not to miss out a clinically significant change of the nodule and not to overburden medical facilities and patients with unnecessary follow-up examinations. Defining optimum surveillance intervals for patients with unsuspicious thyroid nodules remains a challenge This was a single centre cohort study in which patients diagnosed with unsuspicious thyroid nodules in whom no treatment was indicated were invited for re-evaluation 5 years after the diagnosis. The primary end point of the study was to estimate the change in nodule size with thyroid ultrasound (US) and the secondary end point was to assess the need for clinical management 5 years after the diagnosis
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