Abstract
BackgroundThyroid nodules are frequently detected by cervical ultrasound examinations. In follow-up studies, malignant as well as benign nodules may exhibit an increase in size.The objective of our investigation was to test whether histologically determined malignant and benign thyroid nodules show differences in growth rates above a defined significance level.MethodsA retrospective ultrasound cohort follow-up study from 4 to 132 months included 26 patients with differentiated carcinomas and 26 patients with adenomas of the thyroid gland. Significance levels were determined by intra- and interobserver variations of volumetric measurements in 25 individuals.ResultsIntra- and interobserver volumetric measurements were highly correlated (r = 0.99 and r = 0.98, respectively), with variations of 28 and 40%, respectively. The growth rates of malignant and benign nodules did not show differences with respect to two sonographic measurements (d = − 0.04, 95%CI(P): 0.41–0.85, P = 0.83). Using shorter increments and multiple measurements, growth rates of malignant nodules revealed significantly higher values (d = 0.16, 95%CI(P): 0.02–0.04, P = 0.039).ConclusionsThe growth rates of benign and malignant thyroid nodules do not appear to differ using two sonographic volumetric measurements. However, due to temporal changes in cellular proliferation and arrest, malignant nodules may exhibit higher growth rates with multiple assessments and shorter increments.
Highlights
Thyroid nodules are frequently detected by cervical ultrasound examinations
Rapid tumor growth occurring in patients who are thought to have simple nodular goiter has been acknowledged as one criterion of malignancy, especially during treatment with levothyroxine [6, 7]
Some patients may refuse an fine-needle aspiration biopsy (FNAB) or the initial FNAB result may be a false negative. Such nodules will be subject to serial follow-up ultrasound examinations. In this retrospective cohort study, we report serial sonographic examinations in 28 malignant and 26 benign thyroid nodules selected from our clinical database and verified by histological analysis
Summary
In follow-up studies, malignant as well as benign nodules may exhibit an increase in size. The objective of our investigation was to test whether histologically determined malignant and benign thyroid nodules show differences in growth rates above a defined significance level. An increase in the size of a thyroid nodule, in particular, should raise concerns about its malignancy [4, 5]. According to most current viewpoints, It has been pointed out that nodules with a diameter of more than 4 cm were thought to harbor a higher risk of malignancy [7]. Others have emphasized how the size of a nodule itself could not be used to predict a benign or malignant nature [11]. Consideration should be given that the risk of cancer is slightly higher in nodules with a diameter of more than 4 cm
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