Abstract
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.
Highlights
The prevalence of palpable thyroid nodules has been estimated to be around 3–7%, while the prevalence on nonpalpable nodules, detected by thyroid ultrasound or incidentally discovered by MRI or carotid Doppler ultrasound, is much higher (20–76%) [1,2,3]
The following data were recorded: sex, age, TSH, number of nodules, diameter of the nodule in case of uninodular goiter, and diameter of the major nodule in case of multinodular goiter; for the aim of the study, we considered in five-year follow-up the following events as relevant: appearance of new nodules larger than 10 mm; appearance of new nodules smaller than 10 mm with characteristics of malignancy; increase in nodule diameter greater than 50% from baseline; appearance of dyspnea, dysphonia, dysphagia, and local discomfort; execution of a fine-needle aspiration (FNA) on the same nodule already examined at baseline or on a new nodule; any other situation that indicates surgery or any other treatment that excluded the patient from follow-up; development of thyroid dysfunction
The events were the following: 38 new nodules, 23 increase of nodule diameter >50% in respect to baseline, 5 increase of nodule diameter
Summary
The prevalence of palpable thyroid nodules has been estimated to be around 3–7%, while the prevalence on nonpalpable nodules, detected by thyroid ultrasound or incidentally discovered by MRI or carotid Doppler ultrasound, is much higher (20–76%) [1,2,3]. 20–48% of patients with a palpable nodule have another nodule detected by ultrasound [4, 5]. Once a thyroid nodule has been detected, further investigations are required, like fine-needle aspiration (FNA), thyroid function test, or scintigraphy [6]. In AACEAME-ETA guidelines for thyroid nodules, it is indicated that the optimal time interval for patients follow-up is 6– 18 months, in lack of specific studies that address this issue [6]
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