Abstract
This Practice Point commentary discusses the findings and limitations of a retrospective analysis by Mihailescu and Schneider, in which the authors investigated the prevalence of thyroid nodular disease and thyroid cancer in a cohort of patients exposed to ionizing radiation during childhood. Thyroid nodular disease and thyroid cancer were both prevalent in this population. Contrary to previous hypotheses, however, multinodularity was not associated with a decreased risk of malignancy, as thyroid cancer was diagnosed in 30.7% of patients with two or more thyroid nodules, each larger than 1cm. In this commentary, I highlight strategies that are critical to effective patient care. When present, multiple thyroid nodules larger than 1cm must be evaluated by fine-needle aspiration cytology in order to reliably exclude thyroid cancer. Although retrospective in design, this investigation provides insight into the natural history of thyroid disease in a unique patient cohort.
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References
Ron E et al. (1989) Thyroid neoplasia following low-dose radiation in childhood. Radiat Res 120: 516–531
Mihailescu DV and Schneider AB (2008) Size, number, and distribution of thyroid nodules and the risk of malignancy in radiation-exposed patients who underwent surgery. J Clin Endocrinol Metab 93: 2188–2193
Frates MC et al. (2006) Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 91: 3411–3417
Iannuccilli JD et al. (2004) Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. J Ultrasound Med 23: 1455–1464
Peccin S et al. (2002) Ultrasonography: is it useful in the diagnostic of cancer in thyroid nodules. J Endocrinol Invest 25: 39–43
Bartolazzi A et al. (2008) Galectin-3-expression analysis in the surgical selection of follicular thyroid nodules with indeterminate fine-needle aspiration cytology: a prospective multicentre study. Lancet Oncol 9: 543–549
Rago T et al. (2007) Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab 92: 2917–2922
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Alexander, E. Does exposure to childhood radiation influence the development of thyroid nodular disease and thyroid cancer risk?. Nat Rev Endocrinol 4, 590–591 (2008). https://doi.org/10.1038/ncpendmet0952
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DOI: https://doi.org/10.1038/ncpendmet0952