Thyroid incidentalomas

Danae A. Delivanis, M. Regina Castro

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Thyroid incidentalomas are nonpalpable, asymptomatic thyroid nodules that are discovered on an imaging study performed to evaluate other structures or during an operation unrelated to the thyroid gland. Thyroid incidentalomas are most commonly detected on ultrasound (US) performed for evaluation of extra-thyroidal structures, followed in frequency by computed tomography (CT), magnetic resonance imaging (MRI), and 18 fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography [PET] ( 18 FDG-PET). Clinically unrecognized thyroid nodules are common and can be found in up to 50–60% of patients at autopsy. Increased use of imaging modalities of better quality in the modern era has resulted in an increased detection of incidental thyroid nodules. Their clinical importance is primarily related to the need to exclude thyroid cancer. The risk of malignancy in these nonpalpable nodules is similar to that of palpable nodules. As result, a thorough sonographic evaluation of the thyroid gland should be performed in the majority of patients with a thyroid incidentaloma. If a thyroid nodule is confirmed, then it should be evaluated in the same fashion as a clinical apparent thyroid nodule. As with most thyroid nodules, the majority will prove to be benign. However, as more studies come into light, we come to realize that the majority of incidental thyroid nodules that harbor cancerous cells are small indolent papillary carcinomas that do not result in increased mortality, and in such cases, a less aggressive and cost-effective approach is advised.

Original languageEnglish (US)
Title of host publicationContemporary Endocrinology
PublisherHumana Press Inc.
Pages153-167
Number of pages15
DOIs
StatePublished - Jan 1 2018

Publication series

NameContemporary Endocrinology
ISSN (Print)2523-3785
ISSN (Electronic)2523-3793

Keywords

  • fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography [PET] ( FDG-PET)
  • Computed tomography (CT)
  • Fine-needle aspiration (FNA)
  • Imaging studies
  • Incidentalomas
  • Magnetic resonance imaging (MRI)
  • Mortality
  • Thyroid cancer
  • Thyroid nodule
  • Thyroid ultrasound (US)

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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