CPM Summer 2019 - 12

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Features

Contemporary
Management of

THYROID
NODULES

T

he incidence of thyroid cancer in the
United States has steadily increased
over the past 3 decades, with the
most substantial increase being
papillary thyroid carcinoma. The mortality
rate from thyroid cancer is relatively stable
with a slight upward trend of 0.7% per year
since 2007. The increased usage of imaging
modalities and subsequently found thyroid
nodules may be responsible in part for this
upward trend, but no definite cause has been
attributed to the rise in thyroid cancer.

With improved diagnostic tests and higher
rates of incidental findings of thyroid nodules,
the American Thyroid Association (ATA)
found it necessary to change the approach to
treatment and management of thyroid lesions.
In the past, radionuclide scans were performed
routinely in the workup of solitary thyroid
nodules to determine risk for malignancy. This
however is no longer the diagnostic mechanism
of choice. New diagnostic practices now opt
for an ultrasound and probably an ultrasound
or FNA as the first diagnostic steps.
Ultrasonography holds an increasingly
important role in identifying and determining
the risk of malignancy in thyroid nodules. The
2015 ATA Nodule and Cancer Guidelines
have outlined the risk of malignancy of a
detected nodule using ultrasonography images
to demonstrate their parameters of benign,
very low, low, intermediate and high suspicion.
By SEJAL J. SHAH, BS
and DAVID GOLDENBERG, MD, FACS
Department of Otolaryngology - Head and Neck Surgery
Penn State Health Milton S. Hershey Medical Center

12 Summer 2019 Central PA Medicine
http://www.dauphincms.org
CPM Summer 2019

Table of Contents for the Digital Edition of CPM Summer 2019
