Abstract
Background With widespread use of diagnostic imaging modalities, incidental thyroid nodules are frequently identified in patients for unrelated reasons. If underlying thyroid cancer risk in such patients is significant, further evaluation becomes imperative. This study evaluates the malignancy rate of incidentally discovered compared to clinically apparent thyroid nodules in surgical patients. Methods A retrospective review of prospectively collected data of 809 patients who underwent thyroidectomy at a tertiary referral center was performed. The association between incidental discovery of thyroid nodules, malignancy rates, and clinicopathologic characteristics was assessed. Results Of 809 patients, 12% (n = 98) had incidental thyroid nodules, where malignancy was found in 65 (66%) of these patients. The overall rate of malignancy identified incidentally by routine imaging was 14% (65/466). Most common imaging modalities leading to detection were ultrasound (32%), computed tomography (29%), and magnetic resonance imaging (23%). Of patients with incidental thyroid nodules harboring malignancy, follicular variant papillary thyroid cancer (PTC) (48%), classical variant PTC (18%), tall cell variant PTC (12%), and diffuse sclerosing variant PTC (12%) were most commonly found. Patients with malignant incidental thyroid nodules had more lymphovascular invasion and positive lymph nodes compared to nonincidental malignant thyroid nodules (53% versus 41% and 47% versus 33%, P < 0.05, respectively). Conclusions Incidentally discovered thyroid nodules by imaging represent an important group of surgical patients with clinically significant rates of underlying malignancy. Patients with incidentally discovered thyroid nodules by imaging should undergo appropriate evaluation and counseling for further surgical treatment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 341-346 |
| Number of pages | 6 |
| Journal | Journal of Surgical Research |
| Volume | 219 |
| DOIs | |
| State | Published - Nov 1 2017 |
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Keywords
- Incidental cancer
- Incidental thyroid nodule
- Thyroid cancer
ASJC Scopus subject areas
- Surgery
Cite this
Clinically significant cancer rates in incidentally discovered thyroid nodules by routine imaging. / Farrá, Josefina C.; Piado, Omar; Liu, Sophia; Ouyang, Wenqi; Teo, Richard; Franco, Alexa M.; Lew, John.
In: Journal of Surgical Research, Vol. 219, 01.11.2017, p. 341-346.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinically significant cancer rates in incidentally discovered thyroid nodules by routine imaging
AU - Farrá, Josefina C.
AU - Piado, Omar
AU - Liu, Sophia
AU - Ouyang, Wenqi
AU - Teo, Richard
AU - Franco, Alexa M.
AU - Lew, John
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background With widespread use of diagnostic imaging modalities, incidental thyroid nodules are frequently identified in patients for unrelated reasons. If underlying thyroid cancer risk in such patients is significant, further evaluation becomes imperative. This study evaluates the malignancy rate of incidentally discovered compared to clinically apparent thyroid nodules in surgical patients. Methods A retrospective review of prospectively collected data of 809 patients who underwent thyroidectomy at a tertiary referral center was performed. The association between incidental discovery of thyroid nodules, malignancy rates, and clinicopathologic characteristics was assessed. Results Of 809 patients, 12% (n = 98) had incidental thyroid nodules, where malignancy was found in 65 (66%) of these patients. The overall rate of malignancy identified incidentally by routine imaging was 14% (65/466). Most common imaging modalities leading to detection were ultrasound (32%), computed tomography (29%), and magnetic resonance imaging (23%). Of patients with incidental thyroid nodules harboring malignancy, follicular variant papillary thyroid cancer (PTC) (48%), classical variant PTC (18%), tall cell variant PTC (12%), and diffuse sclerosing variant PTC (12%) were most commonly found. Patients with malignant incidental thyroid nodules had more lymphovascular invasion and positive lymph nodes compared to nonincidental malignant thyroid nodules (53% versus 41% and 47% versus 33%, P < 0.05, respectively). Conclusions Incidentally discovered thyroid nodules by imaging represent an important group of surgical patients with clinically significant rates of underlying malignancy. Patients with incidentally discovered thyroid nodules by imaging should undergo appropriate evaluation and counseling for further surgical treatment.
AB - Background With widespread use of diagnostic imaging modalities, incidental thyroid nodules are frequently identified in patients for unrelated reasons. If underlying thyroid cancer risk in such patients is significant, further evaluation becomes imperative. This study evaluates the malignancy rate of incidentally discovered compared to clinically apparent thyroid nodules in surgical patients. Methods A retrospective review of prospectively collected data of 809 patients who underwent thyroidectomy at a tertiary referral center was performed. The association between incidental discovery of thyroid nodules, malignancy rates, and clinicopathologic characteristics was assessed. Results Of 809 patients, 12% (n = 98) had incidental thyroid nodules, where malignancy was found in 65 (66%) of these patients. The overall rate of malignancy identified incidentally by routine imaging was 14% (65/466). Most common imaging modalities leading to detection were ultrasound (32%), computed tomography (29%), and magnetic resonance imaging (23%). Of patients with incidental thyroid nodules harboring malignancy, follicular variant papillary thyroid cancer (PTC) (48%), classical variant PTC (18%), tall cell variant PTC (12%), and diffuse sclerosing variant PTC (12%) were most commonly found. Patients with malignant incidental thyroid nodules had more lymphovascular invasion and positive lymph nodes compared to nonincidental malignant thyroid nodules (53% versus 41% and 47% versus 33%, P < 0.05, respectively). Conclusions Incidentally discovered thyroid nodules by imaging represent an important group of surgical patients with clinically significant rates of underlying malignancy. Patients with incidentally discovered thyroid nodules by imaging should undergo appropriate evaluation and counseling for further surgical treatment.
KW - Incidental cancer
KW - Incidental thyroid nodule
KW - Thyroid cancer
UR - http://www.scopus.com/inward/record.url?scp=85025130966&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85025130966&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2017.06.050
DO - 10.1016/j.jss.2017.06.050
M3 - Article
C2 - 29078903
AN - SCOPUS:85025130966
VL - 219
SP - 341
EP - 346
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
ER -