6: Thyroid nodules and thyroid cancer.
Thyroid nodules are common clinically (prevalence, about 5%) and even more common on ultrasound examination (about 25%). About 5% of thyroid nodules are malignant. Most thyroid cancers are well-differentiated papillary or follicular tumours with an excellent prognosis (10-year survival, 80%-95%). The incidence of papillary thyroid cancer appears to be increasing on the east coast of Australia. Fine-needle aspiration biopsy of the thyroid is the most cost-effective diagnostic tool. Recommended initial management of all follicular carcinomas and of papillary carcinomas > 1.0 cm is total thyroidectomy followed by radioiodine ablation. Most patients should be managed postoperatively with doses of thyroid hormone sufficient to suppress plasma levels of thyroid-stimulating hormone. Recurrences can occur many years after initial therapy, and follow-up should be lifelong. Thyroid nodules are very common, but have a relatively low risk of malignancy
Department of Endocrinology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Emily J
EJ
Mackenzie
Robin H
RH
Mortimer
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D000465:Algorithms; D001707:Biopsy, Needle / Q000379:methods; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000601:surgery; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy
D007457:Iodine Radioisotopes