Evaluation of the thyroid nodule.
BACKGROUND
Clinically detectable thyroid nodules occur in up to 4% of the population in the United States. With ultrasound, nodules may be found in up to 50% of those over 50 years of age.


METHODS
The author reviews his own experience as well as that of others to define a sound clinical approach to the differential diagnosis and detection of thyroid cancer.


RESULTS
Prior neck irradiation is a risk factor for thyroid malignancy. The association of a thyroid nodule with enlarged lymph nodes or fixation of the nodule to strap muscles or the trachea suggests malignancy. A diffusely multinodular gland is usually benign.


CONCLUSIONS
Thyroid function tests rarely help a differential diagnosis. Fine-needle aspiration is the "gold standard" for diagnosis. Tiny "incidentalomas" are often followed with repeat monitoring for change of size or character.
McCaffrey
T V
TV
Department of Otolaryngology Head and Neck Surgery, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612, USA.
D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D006801:Humans; D010808:Physical Examination; D012307:Risk Factors; D013960:Thyroid Function Tests; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology