[Management of isolated thyroid nodules. Conclusion].
From a functional point of view, the present management of solitary thyroid nodules should no longer include the first-intention assay of FT3 and FT4 but that of sensitive TSH only. From an oncological point of view, is should be aimed at leading to surgery all malignant solitary thyroid nodules and sparing it to as many benign nodules as possible, except when justified by cosmetic reasons or by pressure symptoms. The principle of systematic surgery for cold nodules with a low uptake should be given up. The clinical examination remains the key to the selection of candidates to surgery; F.N.A. should become almost systematic, as may the measurement of plasma calcitonin. According to the local facilities, ultrasonography or radionuclide scanning, especially with thallium, can be used to help to refine indications. Infraclinical "nodules", which are purely ultrasonographic images, can be ignored, at least in first intention.
Proye
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Service de Chirurgie Générale et Endocrinienne, Clinique Chirurgicale Adultes Est, Hôpital Huriez 1, Lille.
D005602:France; D006801:Humans; D007883:Legislation, Medical; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000191:economics / Q000601:surgery; D013965:Thyroidectomy / Q000191:economics
Prise en charge du nodule thyroïdien isolé. Conclusion.