About: Goiter is a(n) research topic. Over the lifetime, 7578 publication(s) have been published within this topic receiving 148170 citation(s).
TL;DR: The aim of the study was to correlate the sonographic and color-Doppler findings with the results of US-guided fine needle aspiration biopsy and of pathologic staging of resected carcinomas to establish the relative importance of US features as risk factors of malignancy and a cost-effective management of nonpalpable thyroid nodules.
Abstract: The aim of the study was to correlate the sonographic [ultrasound (US)] and color-Doppler (CFD) findings with the results of US-guided fine needle aspiration biopsy (FNA) and of pathologic staging of resected carcinomas to establish: 1) the relative importance of US features as risk factors of malignancy; and 2) a cost-effective management of nonpalpable thyroid nodules. Four hundred ninety-four consecutive patients with nonpalpable thyroid nodules (8–15 mm) were evaluated by US, CFD, and US-FNA. Ninety-two patients with inadequate cytology were excluded from the study. All patients with suspicious or malignant cytology underwent surgery, whereas subjects with benign cytology had clinical and US control 6 months later. Thyroid malignancies were observed in 18 of 195 (9.2%) solitary thyroid nodules and in 13 of 207 (6.3%) multinodular goiters. Cancer prevalence was similar in nodules greater or smaller than 10 mm (9.1 vs. 7.0%). Extracapsular growth (pT4) was present in 35.5%, and nodal involvement in 19.4...
TL;DR: The data strongly support the use of more extensive initial surgery in class I and II patients with tumors more than 1 cm in size as well as postoperative radioactive 131I ablation of thyroid remnant tissue.
Abstract: We have analyzed the course of papillary thyroid carcinoma in 269 patients managed at the University of Chicago, with an average follow-up period of 12 yr from the time of diagnosis. Patients were categorized by clinical class; I, with intrathyroidal disease; II, with cervical nodal metastases; III, with extrathyroidal invasion; and IV, with distant metastases. Half of the patients had a history of thyroid enlargement known, on the average, for over 3 yr. In 15% of patients given thyroid hormone, the mass decreased in size. The peak incidence of cancer was when subjects were between 20–40 yr of age. Tumors averaged 2.4 cm in size; 21.6% had tumor capsule invasion, and 46% of patients had multifocal tumors. Sixty-six percent of the patients had near-total or total thyroidectomy. The overall incidence of postoperative hypoparathyroidism was 8.4%, but the incidence was zero in 83 near-total or total thyroidectomies carried out by 1 surgeon. Twenty-five percent of the patients had continuing or recurrent dise...
Mark Vanderpump1•Institutions (1)
01 Sep 2011-British Medical Bulletin
TL;DR: The iodine supplementation of populations with mild-to-moderate iodine deficiency and an evidence-based strategy for the risk stratification, treatment and follow-up of benign nodular thyroid disease are recommended.
Abstract: Introduction: Thyroid disorders are prevalent and their manifestations aredetermined by the dietary iodine availability.Sources of data: Data from screening large population samples from USA andEurope.Areas of agreement: The most common cause of thyroid disorders worldwide isiodine deﬁciency, leading to goitre formation and hypothyroidism. In iodine-replete areas, most persons with thyroid disorders have autoimmune disease.Areas of controversy: Deﬁnition of thyroid disorders, selection criteria used,inﬂuence of age and sex, environmental factors and the different techniquesused for assessment of thyroid function.Growing points: Increasing incidence of well-differentiated thyroid cancer.Environmental iodine inﬂuences the epidemiology of non-malignant thyroiddisease.Areas timely for developing research: Iodine supplementation of populationswith mild-to-moderate iodine deﬁciency. An evidence-based strategy for the riskstratiﬁcation, treatment and follow-up of benign nodular thyroid disease. Isthere any beneﬁt in screening adults for thyroid dysfunction?
TL;DR: The alterations in maternal thyroid function during gestation are intricate and far from fully understood, and regulation of the maternal thyroid is complex, resulting from both elevated hCG and increasing TSH.
Abstract: A prospective study was undertaken in 606 healthy women during pregnancy to evaluate the changes occurring in maternal thyroid economy as a result of 1) the increased thyroid hormone-binding capacity of serum, 2) the effects of increased levels of hCG on TSH and on the thyroid, and 3) a marginally low iodine intake in the population (50-75 micrograms/day). Four main features were observed. First, thyroidal activity adjusted to the marked increase in serum T4-binding globulin: pregnancy was accompanied by an overall reduction in the T4/T4-binding globulin ratio, with lower free T4 and T3 levels, although in most cases free hormone levels remained within the normal range. The adjustment of thyroidal output of T4 and T3 did not occur similarly in all subjects. In approximately one third of the women, there was relative hypothyroxinemia, higher T3/T4 ratios (presumably indicating preferential T3 secretion), and higher, although normal, serum TSH concentrations. Second, high hCG levels were associated with thyroid stimulation, both functionally (lower serum TSH) and anatomically (increased thyroid size). The data are consistent with a TSH-like effect of hCG on the thyroid. Hence, regulation of the maternal thyroid is complex, resulting from both elevated hCG (mainly in the first half of gestation) and increasing TSH (mainly in the second half of gestation). Third, a significant increase in serum thyroglobulin levels was observed throughout gestation, especially during the last trimester. Fourth, increased thyroid volume was common, and goiter formation not uncommon (goiter was found in 9% of women at delivery). In conclusion, the alterations in maternal thyroid function during gestation are intricate and far from fully understood. In areas of marginally low iodine intake, gestation is associated in a significant number of women with relative hypothyroxinemia, increased thyroglobulin, and enlarged thyroid.