Abstract

PEDROZA BALLESTEROS, Audel. Thyroid nodule management: a literature review. rev. colomb. cir. [online]. 2008, vol.23, n.2, pp.100-111. ISSN 2011-7582.

Thyroid nodules are frequent and mostly benign. Objective of clinical examination is to try to define if the nodule is malignant. A variety of diagnostic studies are available to the physician, but fine needle aspiration is considered the method of reference in the evaluation of a thyroid nodule. Echography is recommended to guide the fine needle aspiration, especially in the case of small, incidental, or partially cystic nodules in which the initial fine needle aspiration yielded insufficient material. When dealing with benign nodules, follow-up should be periodic every six or twelve months, including thyrotropin serum levels, careful examination of the neck, and fine needle aspiration when the nodule exhibits increase in size or any other suspicious sign. In functioning benign nodules, treatment with 131 iodine is considered the treatment off choice, although surgery is an alternative, especially when the nodule is of large size or partially cystic, or if the patient is of young age. It is also the treatment of choice when thyrotropin levels are diminishing or there is associated hyperthyroidism, because of the effects on bones and the cardiovascular system. For benign non-functioning nodules there is clinical recommendation for prescribing levothyroxin, although this therapy is considered when thyrotropin levels are suppressed, in patients older than 60 years, or in postmenopausic women. When using levothyroxin, one should periodically determine serum thyrotropin levels.

Keywords : thyroid nodule; thyroid function tests; diagnosis; biopsy; fine-needle; ultrasonography; surgery.

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