A study on thyroid nodules without preoperative malignant features

Takanori Nishiyama, Koji Sakamoto, Fumihiro Ito, Seiichi Shinden, Kaoru Ogawa

Research output: Contribution to journalArticle

Abstract

When a thyroid nodule has malignant features found by some examinations (e.g. Echo, FNAC, CT), we perform surgical resection. But if the thyroid nodule does not have malignant feature, there is still the possibility of malignancy, especially when the nodule is large. In the case of large pre-operatively benign thyroid nodules, we therefore consider a diagnostic lobectomy. There is, however, no definite recommendation how large a nodule should be before a lobectomy is performed, and how many malignancies exist in pre-opera-tively benign nodules. In our hospital, we consider surgical resection when the diameter of the thyroid nodule is over 3 cm. In this study, we analyze pre-operatively benign thyroid nodules in which surgical resection was performed in our hospital, how many malignant nodules there were and what the characteristics were between benign or malignant nodule. From 2005 April to 2012 June, 351 patients underwent a lobectomy in our hospital, 70 of which were pre-operatively benign thyroid nodules with diameters of over 3 cm. We analyzed the pathological findings and compared the nodule diameters, serum thyroglobulin, FNAC's classification and some characteristics of echography between pathologically benign and malignant cases. Fifty-eight patients (83%) had pathologically benign nodules, and 12 patients (17%) had malignant nodules. In 58 benign nodules, 33 nodules (47%) were adenomatous goiter, 24 patients (34%) had follicular adenomas and 1 nodule (1%) was an atypical adenoma. In the 12 malignant patients, 8 patients (11%) had papillary adenocarcinoma and 4 patients (6%) had follicular adenocarcinoma. Almost no significant characteristics were found concerning malignancy, in diameter, serum thyroglobulin, class of FNAC and features of echography. As for complications after surgery, hypothyroidism occured in four patients (6%), and neither hypoparathyroidism nor vocal fold paralysis occurred. We concluded that pre-operatively benign thyroid nodule that were over 3 cm in diameter had about a 17% possibility of malignancy. Examinations may not distinguish whether such pre-operatively benign tumors are benign or malignant before surgical resection. We should therefore consider whether to perform therapeutic surgery or not in such patients.

Original languageEnglish
Pages (from-to)102-103
Number of pages2
JournalPractica Otologica, Supplement
Volume141
DOIs
Publication statusPublished - 2015

Fingerprint

Thyroid Nodule
Thyroglobulin
Neoplasms
Adenoma
Ultrasonography
Follicular Adenocarcinoma
Papillary Adenocarcinoma
Hypoparathyroidism
Vocal Cords
Goiter
Hypothyroidism
Serum
Paralysis

Keywords

  • Benign thyroid nodule
  • Diagnosis
  • Lobectomy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

A study on thyroid nodules without preoperative malignant features. / Nishiyama, Takanori; Sakamoto, Koji; Ito, Fumihiro; Shinden, Seiichi; Ogawa, Kaoru.

In: Practica Otologica, Supplement, Vol. 141, 2015, p. 102-103.

Research output: Contribution to journalArticle

Nishiyama, Takanori ; Sakamoto, Koji ; Ito, Fumihiro ; Shinden, Seiichi ; Ogawa, Kaoru. / A study on thyroid nodules without preoperative malignant features. In: Practica Otologica, Supplement. 2015 ; Vol. 141. pp. 102-103.
@article{8b88d1b259e2433f8dc144aae6166b3c,
title = "A study on thyroid nodules without preoperative malignant features",
abstract = "When a thyroid nodule has malignant features found by some examinations (e.g. Echo, FNAC, CT), we perform surgical resection. But if the thyroid nodule does not have malignant feature, there is still the possibility of malignancy, especially when the nodule is large. In the case of large pre-operatively benign thyroid nodules, we therefore consider a diagnostic lobectomy. There is, however, no definite recommendation how large a nodule should be before a lobectomy is performed, and how many malignancies exist in pre-opera-tively benign nodules. In our hospital, we consider surgical resection when the diameter of the thyroid nodule is over 3 cm. In this study, we analyze pre-operatively benign thyroid nodules in which surgical resection was performed in our hospital, how many malignant nodules there were and what the characteristics were between benign or malignant nodule. From 2005 April to 2012 June, 351 patients underwent a lobectomy in our hospital, 70 of which were pre-operatively benign thyroid nodules with diameters of over 3 cm. We analyzed the pathological findings and compared the nodule diameters, serum thyroglobulin, FNAC's classification and some characteristics of echography between pathologically benign and malignant cases. Fifty-eight patients (83{\%}) had pathologically benign nodules, and 12 patients (17{\%}) had malignant nodules. In 58 benign nodules, 33 nodules (47{\%}) were adenomatous goiter, 24 patients (34{\%}) had follicular adenomas and 1 nodule (1{\%}) was an atypical adenoma. In the 12 malignant patients, 8 patients (11{\%}) had papillary adenocarcinoma and 4 patients (6{\%}) had follicular adenocarcinoma. Almost no significant characteristics were found concerning malignancy, in diameter, serum thyroglobulin, class of FNAC and features of echography. As for complications after surgery, hypothyroidism occured in four patients (6{\%}), and neither hypoparathyroidism nor vocal fold paralysis occurred. We concluded that pre-operatively benign thyroid nodule that were over 3 cm in diameter had about a 17{\%} possibility of malignancy. Examinations may not distinguish whether such pre-operatively benign tumors are benign or malignant before surgical resection. We should therefore consider whether to perform therapeutic surgery or not in such patients.",
keywords = "Benign thyroid nodule, Diagnosis, Lobectomy",
author = "Takanori Nishiyama and Koji Sakamoto and Fumihiro Ito and Seiichi Shinden and Kaoru Ogawa",
year = "2015",
doi = "10.5631/jibirinsuppl.141.102",
language = "English",
volume = "141",
pages = "102--103",
journal = "Practica Otologica, Supplement",
issn = "0912-1870",
publisher = "Society of Practical Otolaryngology",

}

TY - JOUR

T1 - A study on thyroid nodules without preoperative malignant features

AU - Nishiyama, Takanori

AU - Sakamoto, Koji

AU - Ito, Fumihiro

AU - Shinden, Seiichi

AU - Ogawa, Kaoru

PY - 2015

Y1 - 2015

N2 - When a thyroid nodule has malignant features found by some examinations (e.g. Echo, FNAC, CT), we perform surgical resection. But if the thyroid nodule does not have malignant feature, there is still the possibility of malignancy, especially when the nodule is large. In the case of large pre-operatively benign thyroid nodules, we therefore consider a diagnostic lobectomy. There is, however, no definite recommendation how large a nodule should be before a lobectomy is performed, and how many malignancies exist in pre-opera-tively benign nodules. In our hospital, we consider surgical resection when the diameter of the thyroid nodule is over 3 cm. In this study, we analyze pre-operatively benign thyroid nodules in which surgical resection was performed in our hospital, how many malignant nodules there were and what the characteristics were between benign or malignant nodule. From 2005 April to 2012 June, 351 patients underwent a lobectomy in our hospital, 70 of which were pre-operatively benign thyroid nodules with diameters of over 3 cm. We analyzed the pathological findings and compared the nodule diameters, serum thyroglobulin, FNAC's classification and some characteristics of echography between pathologically benign and malignant cases. Fifty-eight patients (83%) had pathologically benign nodules, and 12 patients (17%) had malignant nodules. In 58 benign nodules, 33 nodules (47%) were adenomatous goiter, 24 patients (34%) had follicular adenomas and 1 nodule (1%) was an atypical adenoma. In the 12 malignant patients, 8 patients (11%) had papillary adenocarcinoma and 4 patients (6%) had follicular adenocarcinoma. Almost no significant characteristics were found concerning malignancy, in diameter, serum thyroglobulin, class of FNAC and features of echography. As for complications after surgery, hypothyroidism occured in four patients (6%), and neither hypoparathyroidism nor vocal fold paralysis occurred. We concluded that pre-operatively benign thyroid nodule that were over 3 cm in diameter had about a 17% possibility of malignancy. Examinations may not distinguish whether such pre-operatively benign tumors are benign or malignant before surgical resection. We should therefore consider whether to perform therapeutic surgery or not in such patients.

AB - When a thyroid nodule has malignant features found by some examinations (e.g. Echo, FNAC, CT), we perform surgical resection. But if the thyroid nodule does not have malignant feature, there is still the possibility of malignancy, especially when the nodule is large. In the case of large pre-operatively benign thyroid nodules, we therefore consider a diagnostic lobectomy. There is, however, no definite recommendation how large a nodule should be before a lobectomy is performed, and how many malignancies exist in pre-opera-tively benign nodules. In our hospital, we consider surgical resection when the diameter of the thyroid nodule is over 3 cm. In this study, we analyze pre-operatively benign thyroid nodules in which surgical resection was performed in our hospital, how many malignant nodules there were and what the characteristics were between benign or malignant nodule. From 2005 April to 2012 June, 351 patients underwent a lobectomy in our hospital, 70 of which were pre-operatively benign thyroid nodules with diameters of over 3 cm. We analyzed the pathological findings and compared the nodule diameters, serum thyroglobulin, FNAC's classification and some characteristics of echography between pathologically benign and malignant cases. Fifty-eight patients (83%) had pathologically benign nodules, and 12 patients (17%) had malignant nodules. In 58 benign nodules, 33 nodules (47%) were adenomatous goiter, 24 patients (34%) had follicular adenomas and 1 nodule (1%) was an atypical adenoma. In the 12 malignant patients, 8 patients (11%) had papillary adenocarcinoma and 4 patients (6%) had follicular adenocarcinoma. Almost no significant characteristics were found concerning malignancy, in diameter, serum thyroglobulin, class of FNAC and features of echography. As for complications after surgery, hypothyroidism occured in four patients (6%), and neither hypoparathyroidism nor vocal fold paralysis occurred. We concluded that pre-operatively benign thyroid nodule that were over 3 cm in diameter had about a 17% possibility of malignancy. Examinations may not distinguish whether such pre-operatively benign tumors are benign or malignant before surgical resection. We should therefore consider whether to perform therapeutic surgery or not in such patients.

KW - Benign thyroid nodule

KW - Diagnosis

KW - Lobectomy

UR - http://www.scopus.com/inward/record.url?scp=84982145846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84982145846&partnerID=8YFLogxK

U2 - 10.5631/jibirinsuppl.141.102

DO - 10.5631/jibirinsuppl.141.102

M3 - Article

VL - 141

SP - 102

EP - 103

JO - Practica Otologica, Supplement

JF - Practica Otologica, Supplement

SN - 0912-1870

ER -