title: Thyroid incidentalomas: prediction of malignancy and management.
abstract: The treatment strategy of an incidentally detected thyroid nodule is controversial. The aim of this study was to establish management criteria for thyroid incidentalomas by defining and formulating the risk factors predicting thyroid malignancy. A prospective database containing 815 consecutive patients who underwent a thyroidectomy for nodular thyroid disease, between January 1992 and May 2003, was studied. Multivariate analyses demonstrated that the independent clinical predictors of malignancy were a fixed nodule and cervical lymphadenopathy on palpation, a euthyroid patient, and a patient age <23 years or >45 years; and independent nodule features significantly associated with malignancy were punctuate calcifications, irregular nodule margin, solid appearance on ultrasonography, and solitary nodule in an euthyroid patient. Using the regression coefficients of four independent ultrasound (US) features, a malignancy risk score of a nodule was calculated as follows. Depending on the score of a thyroid nodule, a simple follow-up, a US-guided fine needle aspiration biopsy or a thyroidectomy, may be offered for management.
authors.affiliation: 4th Department of Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Atli
authors.forename: Murat
authors.initials: M
authors.lastname: Akgul
authors.forename: Mustafa
authors.initials: M
authors.lastname: Saryal
authors.forename: Gul
authors.initials: G
authors.lastname: Daglar
authors.forename: Ahmet Cinar
authors.initials: AC
authors.lastname: Yasti
authors.forename: Nuri Aydin
authors.initials: NA
authors.lastname: Kama
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008206:Lymphatic Diseases; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy; D014463:Ultrasonography