The solitary thyroid nodule: diagnosis and management of malignant disease

Journal Article · · Am. J. Otolaryngol.; (United States)

DOI:https://doi.org/10.1016/S0196-0709(83)80006-4· OSTI ID:6834028

Lawson, W; Biller, H F

While few solitary thyroid nodules are carcinomatous, it is essential to identify and preferentially select those that are for surgery. Clinical, biochemical, serologic, radiographic, scintigraphic, sonographic, biopsy, and even therapeutic evaluation may be necessary to choose those patients with the greatest probability of malignancy. The benefits and limitations of each diagnostic modality are discussed, and the importance of fine-needle aspiration is stressed. After the operative confirmation of malignancy, the prognosis in any given case depends on 1) the histologic type of the neoplasm, 2) its size and extent, 3) the presence of angioinvasiveness, 4) the tendency toward multicentricity of the lesion, 5) the age and sex of the patient, and 6) whether distant metastases are present. These factors influence the extent of surgery required for well-differentiated carcinomas. Meticulous dissection and preservation of the recurrent laryngeal nerves and the parathyroid glands along with their blood supply are important if total thyroidectomy for papillary carcinoma is to be employed with an acceptable operative morbidity to optimize survival. The value of the adjunctive use of thyroid hormone and radioactive iodine is also discussed. Finally, the clinical behaviors and treatments of undifferentiated carcinomas, sarcomas, lymphomas, and neoplasms metastatic to the thyroid gland are reviewed.

• Research Organization: Department of Otolaryngology, Mount Sinai Medical Center, New York, New York
• OSTI ID: 6834028
• Journal Information: Am. J. Otolaryngol.; (United States), Journal Name: Am. J. Otolaryngol.; (United States) Vol. 4:1; ISSN AJOTD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BODY
CARCINOMAS
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ENDOCRINE GLANDS
GLANDS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
RADIOISOTOPE SCANNING
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SCINTISCANNING
THYROID