The American Journal of Surgery
Volume 197, Issue 3 , Pages 320-324, March 2009

Incidental thyroid nodule: patterns of diagnosis and rate of malignancy

  • Judy Jin, M.D.

      Affiliations

    • Department of Surgery, University Hospitals Case Medical Center, School of Medicine, Cleveland, Ohio, United States
    • ,
  • Scott M. Wilhelm, M.D.

      Affiliations

    • Department of Surgery, University Hospitals Case Medical Center, School of Medicine, Cleveland, Ohio, United States
    • ,
  • Christopher R. McHenry, M.D.

      Affiliations

    • Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, School of Medicine, Cleveland, Ohio, United States
    • Corresponding Author InformationCorresponding author. Tel.: +01-216-778-4753; fax: +01-216-778-3774

Received 2 August 2008; received in revised form 20 October 2008

Abstract 

Background

The clinical significance of thyroid incidentalomas is controversial.

Methods

The rate of malignancy was determined for patients with an incidentally discovered thyroid nodule, and results were stratified according to imaging modality as well as presence and type of pre-existing malignancy.

Results

One hundred fifty patients were identified, of which 88 with a known malignancy were screened for metastases. Twenty-three (15%) patients were diagnosed with thyroid malignancy. Incidental nodules identified on positron emission tomography scan were malignant in 33% of the patients compared with 11% for those identified on computed axial tomography (P = .016). The rate of thyroid malignancy in patients with pre-existing nonthyroid malignancy (18%) was not significantly different from patients without a history of malignancy (13%, P = .36).

Comments

Thyroid incidentalomas are associated with a high rate of malignancy. The rate of malignancy is highest for nodules discovered on positron emission tomography scan and is no different in patients with or without pre-existing malignancy.

Keywords: Imaging modality, Incidental thyroid nodule, Malignancy, Pre-existing malignancy, Thyroid incidentaloma

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PII: S0002-9610(08)00777-0

doi:10.1016/j.amjsurg.2008.10.006

The American Journal of Surgery
Volume 197, Issue 3 , Pages 320-324, March 2009

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