Management Approach to Thyroid Nodules

作     者：Rodrigo Arrangoiz Fernando Cordera David Caba Eduardo Moreno Enrique Luque de Leon Manuel Munoz 

作者机构：Sociedad Quirúrgica S.C.at the American British Cowdray Medical CenterMexico CityMexico 

出 版 物：《International Journal of Otolaryngology and Head & Neck Surgery》 (耳鼻喉（英文）)

年 卷 期：2018年第7卷第4期

页      面：214-227页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Thyroid Nodules Thyroid Cancer Thyroid FNA Thyroid Nodule Workup 

摘      要：Thyroid nodules are a major health problem worldwide. The prevalence of palpable thyroid nodules in the general population is approximately 5% in women and 1% in men living in parts of the world with sufficient iodine. High resolution neck and thyroid ultrasound can detect thyroid nodules in a significant proportion of randomly selected individuals, with higher frequencies in women and the elderly population. The importance of thyroid nodules lies in the need to rule out cancer. The majority of thyroid nodules are benign, clinically irrelevant, and can be safely managed with a good surveillance program. The detection and diagnosis of differentiated thyroid cancer have evolved over the years with increased use of high resolution cervical and thyroid ultrasound, fine needle aspiration biopsy (FNAB), molecular testing, and thyroglobulin as a serum tumor marker. An algorithm that utilizes high resolution ultrasound and, when indicated, FNAB, and molecular testing for the diagnosis of thyroid nodules, facilitates a personalized, risk-based protocol that promotes high-quality care and minimizes cost and unnecessary testing. Our paper reviews the current, evidence-based management of newly diagnosed thyroid nodules.