Management of nodular thyroid disease

doi:10.1136/bmj.323.7308.293

BMJ 2001;323:293-294 ( 11 August )

Editorials

Management of nodular thyroid disease

The challenge remains identifying which palpable nodules are malignant

The first 150 words of the full text of this article appear below.

Thyroid nodules are found in 5% of middle aged women and are commoner in women than in men. A nodule raises concerns aboutmalignant disease, but thyroid cancer is rare, accounting forabout 1000 new cases in England and Wales each year. The mainaim of management is to identify the small proportion of patientswith thyroid cancer who require treatment and avoid unnecessarytesting and treatment for themajority.

Nodules are more likely to be malignant in men, particularly men aged over 70.¹ A history of neck irradiation, rapid tumourgrowth, or a family history of thyroid cancer increases risk.Physical signs associated with increased risk include firm, non-tendernodules, local lymphadenopathy, and recurrent laryngeal nervepalsy in the absence of previous surgery. The incidence of cancerin those with clinical features strongly suggestive of malignancyis high,² but most patients do not have thesefeatures.

Solitary nodules are more . . . [Full text of this article]

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Nodular thyroid disease: G L Sayer and M Keston Jones
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Sayer, G L, Jones, M K. (2001). Nodular thyroid disease. BMJ 323: 1184-1184 [Full text]

Rapid Responses:

Read all Rapid Responses

Are thyroid function tests helpful in the diagnosis of nodular thyroid disease?: G L Sayer
bmj.com, 13 Aug 2001 [Full text]
Management of nodular thyroid disease. Is there a role for ultrasound guided FNAC?: Ricard Simo
bmj.com, 29 Aug 2001 [Full text]
Measurement of hTERT in the Management of Thyroid Nodules: K L Kirkpatrick, et al.
bmj.com, 2 Sep 2001 [Full text]
Author's reply: M Keston Jones
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