Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-008-0052-6
Annals of Surgical Oncology 15:2487-2492 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Méndez, W.
Right arrow Articles by Solórzano, C. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Méndez, W.
Right arrow Articles by Solórzano, C. C.

Original Article

Role of Surgeon-Performed Ultrasound in Predicting Malignancy in Patients with Indeterminate Thyroid Nodules

William Méndez, MD1,2, Steven E. Rodgers, MD, PhD2, John I. Lew, MD2, Raquel Montano, BS2 and Carmen C. Solórzano, MD, FACS2

1 Department of Surgery, University of Puerto Rico School of Medicine, San Juan, PR, USA
2 Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Miller School of Medicine, 1475 NW 12th Ave., Sylvester Cancer Center Room 3550, Miami, FL 33136, USA

Correspondence: Address correspondence and reprint requests to: Carmen C. Solórzano, MD, FACS; E-mail: csolorzano{at}med.miami.edu

Background: Certain ultrasound features can predict malignancy in patients with thyroid nodules. The purpose of this study was to determine the value of surgeon-performed ultrasound (SUS) in predicting thyroid malignancy in patients with indeterminate fine-needle aspiration (FNA) cytology.

Methods: 477 consecutive patients with dominant thyroid nodules were referred to our institution from 2002 to 2007. Of these, 180/477(38%) were judged to have indeterminate cytology: follicular neoplasm (FN, n = 108), Hürthle neoplasm (HN, n = 29), and suspicious for papillary thyroid cancer (SPTC, n = 43). SUS characteristics for thyroid nodules were recorded in a prospective database prior to thyroidectomy. Variables analyzed included patients’ age and sex, nodule size, shape, echogenicity, consistency, borders, multiplicity/multi-centricity, and presence of microcalcifications. SUS features of thyroid nodules were correlated with final pathology. The accuracy of individual SUS features as well as the presence of two or more adverse features in predicting malignancy was also examined.

Results: There were 144 females and 36 males. Mean age was 52 years (range 17–87 years). Mean tumor size was 2.7 cm (range 0.65–6.6 cm). Overall, final pathology revealed cancer in 92/180 (51%) patients. Malignancy was present in 40/108 (37%) FN, 12/29 (41%) HN, and 40/43 (93%) SPTC. Nodule borders (irregular), shape (height > width), hypoechogenicity, and presence of microcalcifications were significantly associated with malignancy. The presence of 2 or ≥3 adverse SUS thyroid nodule features was associated with a ≥55% or ≥78% risk of malignancy, respectively.

Conclusion: Adverse thyroid nodule features seen on SUS may predict malignancy and help determine the initial extent of thyroidectomy in patients with indeterminate FNA cytology.

Key Words: Thyroid cancer • Thyroid nodules • Indeterminate • Ultrasound • FNA






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.