Database : MEDLINE
Search on : Thyroid and Nodule [Words]
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[PMID]: 29522260
[Au] Autor:Iwata AJ; Bhan A; Lahiri S; Williams AM; Taylor AR; Chang SS; Singer MC
[Ad] Address:Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan.
[Ti] Title:Comparison of incidental versus palpable thyroid nodules presenting for fine-needle aspiration biopsy.
[So] Source:Head Neck;, 2018 Mar 09.
[Is] ISSN:1097-0347
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Many attribute the rise in incidence of thyroid cancer to a deluge of radiologically identified incidental thyroid nodules. The clinical implications are unclear. METHODS: A review was performed of all patients who underwent fine-needle aspirations of thyroid nodules by our academic medical center's Endocrinology Division between 2006 and 2010. Medical records were reviewed to identify whether the thyroid nodule was discovered incidentally or by palpation. RESULTS: Of 1153 patients, 37.4% underwent a biopsy because of an incidental thyroid nodule. These patients were significantly more likely to be >45 years old, men, white race, and with a body mass index >30 kg/m . Of the 17.2% of incidentalomas that led to surgery, 8.5% were found to be thyroid cancer. CONCLUSION: Thyroid nodules discovered incidentally are increasing the diagnosis of subclinical thyroid cancers. Not investigated previously, our study found that the mode of detection was not related to malignancy or surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/hed.25132

  2 / 8133 MEDLINE  
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[PMID]: 29520656
[Au] Autor:Angell TE; Vyas CM; Barletta JA; Cibas ES; Cho NL; Doherty GM; Gawande AA; Howitt BE; Krane JF; Marqusee E; Strickland KC; Alexander EK; Moore FD; Nehs MA
[Ad] Address:The Thyroid Section, Division of Endocrinology, Diabetes and Hypertension, The Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
[Ti] Title:Reasons Associated with Total Thyroidectomy as Initial Surgical Management of an Indeterminate Thyroid Nodule.
[So] Source:Ann Surg Oncol;, 2018 Mar 08.
[Is] ISSN:1534-4681
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Diagnostic hemithyroidectomy (HT) is the most widely recommended surgical procedure for a nodule with indeterminate cytology; however, additional details may make initial total thyroidectomy (TT) preferable. We sought to identify patient-specific factors (PSFs) associated with initial TT in patients with indeterminate thyroid nodules. METHODS: Retrospective analysis of all patients with a thyroid nodule ≥ 1 cm and initial cytology of atypia of undetermined significance or suspicious for follicular neoplasm between 2012 and 2015 who underwent thyroidectomy. Medical records were reviewed for patient demographics, neck symptoms, nodule size, cytology, molecular test results, final histopathology, and additional PSFs influencing surgical management. Variables were analyzed to determine associations with the use of initial TT. Logistic regression analyses were performed to identify independent associations. RESULTS: Of 325 included patients, 182/325 (56.0%) had HT and 143/325 (44.0%) had TT. While patient age and sex, nodule size, and cytology result were not associated with initial treatment, five PSFs were associated with initial TT (p < 0.0001). These included contralateral nodules, hypothyroidism, fluorodeoxyglucose avidity on positron emission tomography scan, family history of thyroid cancer, and increased surgical risk. At least one PSF was present in 126/143 (88.1%) TT patients versus 47/182 (25.8%) HT patients (p < 0.0001). Multivariate logistic regression analysis demonstrated that these variables were the strongest independent predictor of TT (odds ratio 45.93, 95% confidence interval 18.80-112.23, p < 0.001). CONCLUSIONS: When surgical management of an indeterminate cytology thyroid nodule was performed, several PSFs were associated with a preference by surgeons and patients for initial TT, which may be useful to consider in making decisions on initial operative extent.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1245/s10434-018-6421-x

  3 / 8133 MEDLINE  
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[PMID]: 29519570
[Au] Autor:Kay-Rivest E; Mascarella MA; Puligandla P; Emil S; Saint-Martin C; Nguyen LHP; Daniel SJ; Baird R
[Ad] Address:Division of Otolaryngology - Head and Neck Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
[Ti] Title:Intrathyroidal thymic tissue in children: Avoiding unnecessary surgery.
[So] Source:J Pediatr Surg;, 2018 Feb 08.
[Is] ISSN:1531-5037
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND/PURPOSE: Intrathyroidal thymic tissue may be misinterpreted as a thyroid lesion in children, leading to invasive tests or resection. We sought to describe the characteristic imaging features of these lesions and to evaluate the safety of non-operative management. METHODS: A retrospective review of all patients less than 18years old with intrathyroidal thymic tissue from 2000 to 2016 was performed. Data collection included patient demographics, imaging results, interventions, and outcomes. RESULTS: Eleven patients were identified using institutional radiology and pathology databases. Median patient age and lesion size at presentation were 5years old (range 2 to 8years old) and 0.9cm (range 0.4 to 9.2cm), respectively. Six lesions were incidentally identified, six were left-sided, and the most common location was the lower pole. Ultrasonographic features were reproducible and included well demarcated (10/11), hypoechoic lesions (11/11), containing punctate/linear internal echoes (11/11), and occasional mild hypervascularity (6/11). All cases demonstrated interval size and echotexture stability over a median surveillance period of 3years (range 1 to 8years). While 9 patients were simply observed, the first patient in this series underwent excision, while another had a fine needle aspiration to confirm pathology. LEVEL OF EVIDENCE: Study of diagnostic test, Level IV. CONCLUSION: Intrathyroidal thymic tissue has typical clinical and sonographic characteristics which allow for appropriate diagnosis and avoids thyroid resection.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 8133 MEDLINE  
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[PMID]: 29427209
[Au] Autor:Teng D; Sui G; Liu C; Wang Y; Xia Y; Wang H
[Ad] Address:Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China.
[Ti] Title:Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study.
[So] Source:J Cancer Res Clin Oncol;144(4):771-779, 2018 Apr.
[Is] ISSN:1432-1335
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: To evaluate the safety and efficacy of ultrasound-guided low-power microwave ablation (MWA) for the treatment of papillary thyroid microcarcinoma (PTMC) with a 3-year follow-up. METHODS: A total of 21 nodules diagnosed as PTMC from the 15 patients were performed with MWA at a power of 20 W. The images of the nodules were recorded by ultrasound before MWA and 1, 3, 6, 12 months after MWA, and every 6 months thereafter, respectively. The volumes of the nodules were compared before MWA and at each follow-up point after MWA. The volume reduction rate (VRR) of nodules was also calculated. RESULTS: The mean volume of the nodules was 134.3 ± 129.8 mm initially (the range was 7.4-423.8 mm ), which decreased significantly to 2.3 ± 10.5 mm (the range was 0-48.1 mm ) of the ablation area (P = 0.000) at the follow-up point of 36 months with a mean VRR as 98.78 ± 5.61% (the range was 74.28-100%). During the follow-up period (the range was 36-48 months), 20 of the 21 nodules were completely absorbed and no recurrent nodule was found. CONCLUSIONS: After a long-term follow-up of 3 years, the low power MWA showed a good safety and efficacy for the treatment of PTMC. In addition to surgery and active surveillance, MWA might be another alternative for patients with PTMC.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s00432-018-2607-7

  5 / 8133 MEDLINE  
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[PMID]: 29517693
[Au] Autor:Huang K; Gao N; Zhai Q; Bian D; Wang D; Wang X
[Ad] Address:Department of Ultrasonic Diagnosis, The First Affiliated Hospital of China Medical University.
[Ti] Title:The anteroposterior diameter of nodules in the risk assessment of papillary thyroid microcarcinoma.
[So] Source:Medicine (Baltimore);97(10):e9712, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:This study investigates the application of ultrasound, especially the anteroposterior diameter of nodules in the malignancy and metastasis risk assessment of papillary thyroid microcarcinoma through a retrospective analysis of 500 cases of thyroid nodule ultrasonography.We selected 500 patients with thyroid nodules (maximum nodule diameter ≤2.0 cm) that had been diagnosed clinically and graded TI-RADS 4c by ultrasonography and surgically treated. Among these, there were 258 cases of pathologically diagnosed papillary thyroid microcarcinoma, 72 cases of nodular goiter or adenoma, 137 cases of papillary thyroid carcinoma, 28 cases of acinar cell carcinoma, and 5 cases of undifferentiated carcinoma. In all cases, color Doppler ultrasonography had been performed preoperatively to determine the size and number of nodules, surrounding lymph node metastasis, and TI-RADS grading. Cases of papillary thyroid microcarcinoma diagnosed by pathology were selected as the study group, and cases of nodular goiter or adenoma as the control group. Each group was further subdivided based on the anteroposterior, vertical, and transverse nodule diameters. Intergroup statistical analysis was also performed. Receiver operating characteristic (ROC) curve analysis was conducted on the study and control groups based on the anteroposterior nodule diameters, and the optimal critical value for malignancy risk was determined. Thyroid nodules in the study group were divided into groups based on the presence or absence of lymph node metastasis. Based on the anteroposterior nodule diameter, ROC curve analysis was performed, and the optimal critical value for metastasis risk was determined.There were 500 cases of malignant nodules diagnosed by ultrasound. Among these, there were 428 cases of malignant nodules diagnosed by pathology. The coincidence rate of the ultrasound diagnosis with pathological diagnosis was 85.60%. While, interestingly, There was a significant statistical difference between the study and control groups based on the anteroposterior nodule diameter. When the anteroposterior nodule diameter was 0.7 cm, sensitivity of malignant diagnosis was 76.70% and specificity of that was 66.70%, and the Youden index was the highest. The lymph node metastasis rate for papillary thyroid microcarcinoma was 13.95%. Within this group, the lymph node metastasis rate for nodules ≥0.9 cm (anteroposterior diameter) was 38.46%. When the anteroposterior nodule diameter was equal to 0.9 cm, sensitivity of diagnosis was 83.30%, and specificity of that was 77.80%, and the Youden index was the highest.The anteroposterior diameter of thyroid nodules is more suitable for assessing their malignancy with 0.7 cm, which can be used as the critical value. Nodules ≥ 0.7 cm require surgical treatment, and those <0.7 cm can be observed. An anteroposterior diameter of 0.9 cm can be used as the critical value for assessing the metastasis risk of malignant thyroid nodules. During surgery, the dissection of central cervical lymph nodes is required for nodules ≥0.9 cm.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1097/MD.0000000000009712

  6 / 8133 MEDLINE  
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[PMID]: 29516937
[Au] Autor:Boz A; Tazegul G; Bozoglan H; Dogan O; Sari R; Altunbas HA; Arici C; Ocak GA; Balci MK
[Ad] Address:Department of Nuclear Medicine, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
[Ti] Title:Bone metastases without primary tumor: A well-differentiated follicular thyroid carcinoma case.
[So] Source:J Cancer Res Ther;14(2):447-450, 2018 Jan-Mar.
[Is] ISSN:1998-4138
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Metastases to the bone are the most common malignant bone tumors. Prostate, breast, and lung carcinomas are the most common primaries of bone metastases. Bone metastases show poor prognosis in means of median survival; however, some patients with highly curable tumors such as thyroid carcinoma may benefit from treatment. We report and discuss a unique case of a 70-year-old female patient presenting with arm pain, diagnosed with metastatic well-differentiated follicular carcinoma without a primary tumor in the thyroid.
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.4103/0973-1482.199391

  7 / 8133 MEDLINE  
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[PMID]: 29516685
[Au] Autor:Mon SY; Riedlinger G; Abbott CE; Seethala R; Ohori NP; Nikiforova MN; Nikiforov YE; Hodak SP
[Ad] Address:Division of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
[Ti] Title:Cancer risk and clinicopathological characteristics of thyroid nodules harboring thyroid-stimulating hormone receptor gene mutations.
[So] Source:Diagn Cytopathol;, 2018 Mar 08.
[Is] ISSN:1097-0339
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Thyroid-stimulating hormone receptor (TSHR) gene mutations play a critical role in thyroid cell proliferation and function. They are found in 20%-82% of hyperfunctioning nodules, hyperfunctioning follicular thyroid cancers (FTC), and papillary thyroid cancers (PTC). The diagnostic importance of TSHR mutation testing in fine needle aspiration (FNA) specimens remains unstudied. METHODS: To examine the association of TSHR mutations with the functional status and surgical outcomes of thyroid nodules, we evaluated 703 consecutive thyroid FNA samples with indeterminate cytology for TSHR mutations using next-generation sequencing. Testing for EZH1 mutations was performed in selected cases. The molecular diagnostic testing was done as part of standard of care treatment, and did not require informed consent. RESULTS: TSHR mutations were detected in 31 (4.4%) nodules and were located in exons 281-640, with codon 486 being the most common. Allelic frequency ranged from 3% to 45%. Of 16 cases (12 benign, 3 FTC, 1 PTC) with surgical correlation, 15 had solitary TSHR mutations and 1 PTC had comutation with BRAF V600E. Hyperthyroidism was confirmed in all 3 FTC (2 overt, 1 subclinical). Of 5 nodules with solitary TSHR mutations detected at high allelic frequency, 3 (60%) were FTC. Those at low allelic frequency (3%-22%) were benign. EZH1 mutations were detected in 2 of 4 TSHR-mutant malignant nodules and neither of 2 benign nodules. CONCLUSION: We report that TSHR mutations occur in ∼5% thyroid nodules in a large consecutive series with indeterminate cytology. TSHR mutations may be associated with an increased cancer risk when present at high allelic frequency, even when the nodule is hyperfunctioning. Benign nodules were however most strongly correlated with TSHR mutations at low allelic frequency.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1002/dc.23915

  8 / 8133 MEDLINE  
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[PMID]: 29514621
[Au] Autor:Liu J; Zheng D; Li Q; Tang X; Luo Z; Yuan Z; Gao L; Zhao J
[Ad] Address:Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, 250021, China.
[Ti] Title:A predictive model of thyroid malignancy using clinical, biochemical and sonographic parameters for patients in a multi-center setting.
[So] Source:BMC Endocr Disord;18(1):17, 2018 Mar 07.
[Is] ISSN:1472-6823
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Thyroid nodules are highly prevalent, but a robust, feasible method for malignancy differentiation has not yet been well documented. This study aimed to establish a practical model for thyroid nodule discrimination. METHODS: Records for 2984 patients who underwent thyroidectomy were analyzed. Clinical, laboratory, and US variables were assessed retrospectively. Multivariate logistic regression analysis was performed and a mathematical model was established for malignancy prediction. RESULTS: The results showed that the malignant group was younger and had smaller nodules than the benign group (43.5 ± 11.6 vs. 48.5 ± 11.5 y, p < 0.001; 1.96 ± 1.16 vs. 2.75 ± 1.70 cm, p < 0.001, respectively). The serum thyrotropin (TSH) level (median = 1.63 mIU/L, IQR (0.89-2.66) vs. 1.19 (0.59-2.10), p < 0.001) was higher in the malignant group than in the benign group. Patients with malignancies tested positive for anti-thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) more frequently than those with benign nodules (TGAb, 30.3% vs. 15.0%, p < 0.001; TPOAb, 25.6% vs. 18.0%, p = 0.028). The prevalence of ultrasound (US) features (irregular shape, ill-defined margin, solid structure, hypoechogenicity, microcalcifications, macrocalcifications and central intranodular flow) was significantly higher in the malignant group. Multivariate logistic regression analysis confirmed that age (OR = 0.963, 95% CI = 0.934-0.993, p = 0.017), TGAb (OR = 4.435, 95% CI = 1.902-10.345, p = 0.001), hypoechogenicity (OR = 2.830, 95% CI = 1.113-7.195, p = 0.029), microcalcifications (OR = 4.624, 95% CI = 2.008-10.646, p < 0.001), and central intranodular flow (OR = 2.155, 95% CI = 1.011-4.594, p < 0.05) were independent predictors of thyroid malignancy. A predictive model including four variables (age, TGAb, hypoechogenicity and microcalcification) showed an optimal discriminatory accuracy (area under the curve, AUC) of 0.808 (95% CI = 0.761-0.855). The best cut-off value for prediction was 0.52, achieving sensitivity and specificity of 84.6% and 76.3%, respectively. CONCLUSION: A predictive model of malignancy that combines clinical, laboratory and sonographic characteristics would aid clinicians in avoiding unnecessary procedures and making better clinical decisions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1186/s12902-018-0241-7

  9 / 8133 MEDLINE  
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[PMID]: 29408952
[Au] Autor:Persichetti A; Di Stasio E; Guglielmi R; Bizzarri G; Taccogna S; Misischi I; Graziano F; Petrucci L; Bianchini A; Papini E
[Ad] Address:Department of Endocrinology & Metabolism, Ospedale Regina Apostolorum, Albano (Rome).
[Ti] Title:Predictive Value of Malignancy of Thyroid Nodule Ultrasound Classification Systems. A Prospective Study.
[So] Source:J Clin Endocrinol Metab;, 2018 Feb 01.
[Is] ISSN:1945-7197
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: British Thyroid Association (BTA), American Thyroid Association (ATA) and American Association of Clinical Endocrinologists (AACE/ACE/AME) recommend for thyroid nodules an ultrasound (US)-based stratification of risk of malignancy. Aim of our study was to assess the diagnostic accuracy of US classification systems and their reliability for indication to fine-needle aspiration (FNA). Methods: Prospective study on 987 thyroid nodules consecutively referred for FNA. US images were independently reviewed by four experts for assignment of malignancy risk. Cytologically benign nodules had confirmation with a second FNA, while Bethesda class IV, V and VI nodules were operated upon. Class III nodules had surgery or follow-up on the basis of clinical, immunocytochemical and US features. Results: BTA: Malignancy rate was 2.8% in benign; 10.0% in indeterminate; 51.3% in suspicion; 80.9% in malignant US class. Sensitivity was 0.74, specificity 0.92, accuracy 0.89. ATA: Malignancy rate was 0.0% in benign; 2.2% in very-low suspicion; 3.0% in low-suspicion; 5.8% in intermediate; and 55.0% in high-suspicion US class. Sensitivity was 0.81, specificity 0.87, accuracy 0.86. AACE/ACE/AME: Malignancy rate was 1.1% in low-risk; 4.4% in intermediate-risk; 54.9% in high-risk US class. Sensitivity was 0.82, specificity 0.87, accuracy 0.86. K-correlation coefficient was 78.9%, 76.9% and 82.0% for BTA, ATA and AACE/ACE/AME classifications. Conclusions: Classification systems had elevated predictive value of malignancy in high-risk classes. ATA and AACE/ACE/AME systems were effective for ruling-out indication to FNA in low US risk nodules. A similar diagnostic accuracy and a substantial inter-observer agreement was provided by the 3- and the 5-category classifications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1210/jc.2017-01708

  10 / 8133 MEDLINE  
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[PMID]: 29240898
[Au] Autor:Ritter A; Bachar G; Hirsch D; Benbassat C; Katz O; Kochen N; Diker-Cohen T; Akirov A; Shimon I; Robenshtok E
[Ad] Address:Department of Otorhinolaryngology, Head and Neck Surgery, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
[Ti] Title:Natural History of Contralateral Nodules After Lobectomy in Patients With Papillary Thyroid Carcinoma.
[So] Source:J Clin Endocrinol Metab;103(2):407-414, 2018 Feb 01.
[Is] ISSN:1945-7197
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: Bilateral thyroid nodularity is considered an indication for total thyroidectomy in papillary thyroid carcinoma (PTC). However, the natural history and outcome of contralateral nodules have never been studied. Objective: To investigate the natural history of nonsuspicious contralateral nodules after lobectomy for PTC. Methods: We included patients who had one or more solid nodules (≥3 mm) in the contralateral lobe with benign cytology before surgery or small nonsuspicious nodules per ultrasonography. Results: One hundred and twelve patients were included. Median age was 57 years, and median size of the PTC (initial lobectomy) was 8 mm (range, 0.5 to 28 mm). On the contralateral side, the median size of nodules was 7 mm (range, 3 to 30 mm). Thirty-three nodules (29%) had fine-needle aspiration (FNA) before surgery, and all were benign. After a median follow-up of 6 years, median growth was zero (range, -20 to 19 mm). Twenty-six nodules (23%) increased ≥3 mm in size (median, 6 mm; range, 4 to 19 mm). Twenty patients (18%) developed new nodules. Twelve patients (11%) underwent completion thyroidectomy for growth (three), suspicious FNA (seven; Bethesda III to V), malignancy (one), or unknown reason (one). Overall, according to the completion thyroidectomy specimen, six patients (5%) were diagnosed with contralateral PTC (five micro-PTCs, one 20 mm), and all were without evidence of disease at the end of follow-up. There were no surgical difficulties or local complications during completion surgery. Conclusions: Lobectomy for low-risk patients with a small PTC and nonsuspicious contralateral thyroid nodule(s) is a reliable and safe initial treatment option. In the few patients who required completion thyroidectomy, treatment with surgery and radioiodine was effective.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1210/jc.2017-01616


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