title: Atypical thyroid cancers on sonography.
abstract: The management of thyroid nodules is a common clinical problem. Thyroid nodules are present in up to 50% of the adult population. However, thyroid malignancy is rare, occurring in only 5% to 15% of nodules. Although certain specific patterns on imaging are almost always indicative of benignity, there is considerable overlap between the sonographic appearances of benign and malignant nodules. Radiologists should be wary of applying pattern recognition approaches too liberally as some malignant nodules may exhibit sonographic features more commonly associated with benign nodules such as cystic change, comet-tail artifact, smooth margins, echogenic echotexture, hypoechoic halos, or peripheral calcifications. This article illustrates atypical imaging appearances of thyroid malignancies and reviews recent literature in an attempt to clarify nuances in the diagnosis of malignancy in benign-appearing nodules.
authors.affiliation: *Department of Radiology, Stanford University School of Medicine, Stanford; and †Department of Radiology, VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Kendra
authors.initials: K
authors.lastname: Klang
authors.forename: Aya
authors.initials: A
authors.lastname: Kamaya
authors.forename: Ali M
authors.initials: AM
authors.lastname: Tahvildari
authors.forename: R Brooke
authors.initials: RB
authors.lastname: Jeffrey
authors.forename: Terry S
authors.initials: TS
authors.lastname: Desser
mesh_terms: D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D035583:Rare Diseases / Q000000981:diagnostic imaging*; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D016606:Thyroid Nodule / Q000145:classification* / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*