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- Title
Natural history of benign solid and cystic thyroid nodules.
- Authors
Alexander, Erik K.; Hurwitz, Shelley; Heering, Jenny P.; Benson, Carol B.; Frates, Mary C.; Doubilet, Peter M.; Cibas, Edmund S.; Larsen, P. Reed; Marqusee, Ellen
- Abstract
<bold>Background: </bold>Thyroid nodules are common and most often benign. The natural history of benign thyroid nodules, however, is unclear.<bold>Objective: </bold>To determine the natural history of cytologically benign thyroid nodules using ultrasonography.<bold>Design: </bold>Retrospective case series.<bold>Setting: </bold>Single tertiary care clinic.<bold>Participants: </bold>All patients referred to the Brigham and Women's Hospital Thyroid Nodule Clinic, Boston, Massachusetts, who had benign cytologic results on ultrasonography-guided fine-needle aspiration of a thyroid nodule between 1995 and 2000 and returned for a requested follow-up examination 1 month to 5 years later.<bold>Measurements: </bold>Nodule dimensions were measured at both visits, and growth was defined as an increase in calculated volume of 15% or greater. These results were correlated with the time between examinations, age, sex, baseline serum thyroid-stimulating hormone concentration, and cystic content of each nodule.<bold>Results: </bold>Nodule volume increased over time (P < 0.001). The estimated proportion of nodules with an increase in volume of 15% or greater after 5 years was 89%. Nodules with greater cystic content were less likely to grow than solid nodules (P = 0.01). Seventy-four of the 330 nodules were reaspirated on the second visit. Despite an average increase in volume of 69%, only 1 of 74 reaspirated nodules was malignant.<bold>Conclusion: </bold>Most solid, benign thyroid nodules grow. Therefore, an increase in nodule volume alone is not a reliable predictor of malignancy.
- Subjects
THYROID gland tumors; THYROTROPIN
- Publication
Annals of Internal Medicine, 2003, Vol 138, Issue 4, p315
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-138-4-200302180-00010