Cuándo operar? | 04 AGO 04

Diferenciación entre nódulos tiroideos benignos y malignos

Hasta el 60% de los adultos de más de 50 años de edad tienen nódulos tiroideos, pero solamente un porcentaje de ellos requiere cirugía.
Autor/a: Dres. Sturgeon C, Clark OH. Fuente: Department of Surgery, University of California San Francisco and UCSF Comprehensive Cancer Center at Mount Zion. Contemporary Surgery 2004; 60(5): 210-216.
1. Kang KW, Kim SK, Kang HS, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab. 2003;88:4100-4104.

2. Nam-Goong IS, Kim HY, Gong G, et al. Ultrasonography-guided fine-needle aspiration of thyroid incidentaloma: correlation with pathological findings. Clin Endocrinol (Oxf). 2004;60:21-28.

3. Cohen MS, Arslan N, Dehdashti F, et al. Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography. Surgery. 2001;130:941-946.

4. Burguera B, Gharib H. Thyroid incidentalomas. Prevalence, diagnosis, significance, and management. Endocrinol Metab Clin North Am. 2000;29:187-203.

5. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997;126:226-231.

6. Hay ID, Klee GG. Thyroid cancer diagnosis and management. Clin Lab Med. 1993;13:725-734.

7. Maddox P, Wheeler M. Approach to thyroid nodules. In: Clark O, Duh Q, eds. Textbook of Endocrine Surgery. Philadelphia, PA: W.B. Saunders; 1997:69-74.
8. Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab. 1955;15:1270-1280.

9. Ross DS. Evaluation and nonsurgical management of the thyroid nodule. In: Randolph G, ed. Surgery of the Thyroid and Parathyroid Glands. Philadelphia, PA: W.B. Saunders; 2003:139-148.

10. Horlocker TT, Hay ID, James EM. Prevalence of incidental nodular thyroid disease detected during high-resolution parathyroid ultrasonography. In: Medeiros-Neto G, Gaitan E, eds. Frontiers of Thyroidology. Vol 2. New York, NY: Plenum Press; 1986:1309-1312.

11. Grebe SK, Hay ID. Follicular cell-derived thyroid carcinomas. Cancer Treat Res. 1997;89:91-140.

12. Derwahl M, Studer H. Multinodular goitre: much more to it than simply iodine deficiency. Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14:577-600.

13. Derwahl M, Broecker M, Kraiem Z. Clinical review 101: Thyrotropin may not be the dominant growth factor in benign and malignant thyroid tumors. J Clin Endocrinol Metab. 1999;84:829-834.

14. Dumont JE, Ermans AM, Maenhaut C, et al. Large goitre as a maladaptation to iodine deficiency. Clin Endocrinol (Oxf). 1995;43:1-10.

15. Eastman CJ, Phillips DI. Endemic goitre and iodine deficiency disorders -aetiology, epidemiology and treatment. Baillieres Clin Endocrinol Metab. 1988;2:719-735.

16. Favus MJ, Schneider AB, Stachura ME, et al. Thyroid cancer occurring as a late consequence of head-and-neck irradiation. Evaluation of 1056 patients. N Engl J Med. 1976;294:1019-1025.

17. Schneider AB, Favus MJ, Stachura ME, et al. Incidence, prevalence and characteristics of radiation-induced thyroid tumors. Am J Med. 1978;64:243-252.

18. Schneider AB, Shore-Freedman E, Ryo UY, et al. Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies. Medicine (Baltimore). 1985;64:1-15.

19. Goldgar DE, Easton DF, Cannon-Albright LA, Skolnick MH. Systematic population-based assessment of cancer risk in firstdegree relatives of cancer probands. J Natl Cancer Inst. 1994;86:1600-1608.

20. Grossman RF, Tu SH, Duh QY, et al. Familial nonmedullary thyroid cancer. An emerging entity that warrants aggressive treatment. Arch Surg. 1995;130:892-899.

21. Loh KC. Familial nonmedullary thyroid carcinoma: a meta-review of case series. Thyroid. 1997;7:107-113.

22. Pal T, Vogl FD, Chappuis PO, et al. Increased risk for nonmedullary thyroid cancer in the first degree relatives of prevalent cases of nonmedullary thyroid cancer: a hospital-based study. J Clin Endocrinol Metab. 2001;86:5307-5312.

23. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993;118:282-289.

24. Lowhagen T, Granberg PO, Lundell G, et al. Aspiration biopsy cytology (ABC) in nodules of the thyroid gland suspected to be malignant. Surg Clin North Am. 1979;59:3-18.

25. Soderstrom N. Puncture of goiters for aspiration biopsy. Acta Med Scand. 1952;144:237-244.

26. Zajicek J. Aspiration biopsy cytology. I. Cytology of supradiaphragmatic organs. Monogr Clin Cytol. 1974;4:1-211.

27. Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proc. 1994;69:44-49.

28. Gharib H, Goellner JR, Johnson DA. Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. Clin Lab Med. 1993;13:699-709.

29. Grant CS, Hay ID, Gough IR, et al. Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses. Surgery. 1989;106:980-986.

30. Gharib H, Goellner JR. Fine needle aspiration biopsy of the thyroid gland. In: Randolph G, ed. Surgery of the Thyroid and Parathyroid Glands. Philadelphia, PA: W.B. Saunders; 2003:149-161.

31. Woeber KA. Cost-effective evaluation of the patient with a thyroid nodule. Surg Clin North Am. 1995;75:357-363.

32. Kresnik E, Gallowitsch HJ, Mikosch P, et al. Fluorine-18-fluorodeoxyglucose positron emission tomography in the preoperative assessment of thyroid nodules in an endemic goiter area. Surgery. 2003;133:294-299.

33. Adler LP, Bloom AD. Positron emission tomography of thyroid masses. Thyroid. 1993;3:195-200.

34. Bloom AD, Adler LP, Shuck JM. Determination of malignancy of thyroid nodules with positron emission tomography. Surgery. 1993;114:728-735.

35. Van den Bruel A, Maes A, De Potter T, et al. Clinical relevance of thyroid fluorodeoxyglucose-whole body positron emission tomography incidentaloma. J Clin Endocrinol Metab. 2002;87:1517-1520.

36. Davis PW, Perrier ND, Adler L, Levine EA. Incidental thyroid carcinoma identified by positron emission tomography scanning obtained for metastatic evaluation. Am Surg. 2001;67:582-584.

37. Feine U, Lietzenmayer R, Hanke JP, et al. Fluorine-18-FDG and iodine-131-iodide uptake in thyroid cancer. J Nucl Med. 1996;37:1468-1472.

38. Wang W, Macapinlac H, Larson SM, et al. [18F]-2-fluoro-2-deoxy-Dglucose positron emission tomography localizes residual thyroid cancer in patients with negative diagnostic (131)I whole body scans and elevated serum thyroglobulin levels. J Clin Endocrinol Metab. 1999;84:2291-2302.

39. Grunwald F, Kalicke T, Feine U, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in thyroid cancer: results of a multicentre study. Eur J Nucl Med. 1999;26:1547-1552.

40. Wang W, Larson SM, Fazzari M, et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab. 2000;85:1107-1113.

41. Grunwald F, Menzel C, Bender H, et al. Comparison of 18FDG-PET with 131iodine and 99mTc-sestamibi scintigraphy in differentiated thyroid cancer. Thyroid. 1997;7:327-335.

42. Hooft L, Hoekstra OS, Deville W, et al. Diagnostic accuracy of 18Ffluorodeoxyglucose positron emission tomography in the follow-up of papillary or follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86:3779-3786.

43. Robbins R, Drucker W, Hann L, Tuttle RM. Advances in the detection of residual thyroid carcinoma. Adv Intern Med. 2001;46:277-294.

44. Mazzaferri EL, Massoll N. Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin. Endocr Relat Cancer. 2002;9:227-247.

45. McGriff NJ, Csako G, Gourgiotis L, et al. Effects of thyroid hormone suppression therapy on adverse clinical outcomes in thyroid cancer. Ann Med. 2002;34:554-564.

46. Pujol P, Daures JP, Nsakala N, et al. Degree of thyrotropin suppression as a prognostic determinant in differentiated thyroid cancer. J Clin Endocrinol Metab. 1996;81:4318-4323.

47. Reverter JL, Lucas A, Salinas I, et al. Suppressive therapy with levothyroxine for solitary thyroid nodules. Clin Endocrinol (Oxf). 1992;36:25-28.

48. Gharib H, James EM, Charboneau JW, et al. Suppressive therapy with levothyroxine for solitary thyroid nodules. A double-blind controlled clinical study. N Engl J Med. 1987;317:70-75.

49. Cheung PS, Lee JM, Boey JH. Thyroxine suppressive therapy of benign solitary thyroid nodules: a prospective randomized study. World J Surg. 1989;13:818-822.

50. Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249-1252.

51. Ross DS. Hyperthyroidism, thyroid hormone therapy, and bone. Thyroid. 1994;4:319-326.

52. Kebebew E, Duh QY, Clark OH. Parathyroidectomy for primary hyperparathyroidism in octogenarians and nonagenarians: a plea for early surgical referral. Arch Surg. 2003;138:867-871.

53. Clark OH, Demling R. Management of thyroid nodules in the elderly. Am J Surg. 1976;132:615-619.

54. Russo D, Wong MG, Costante G, et al. A Val 677 activating mutation of the thyrotropin receptor in a Hurthle cell thyroid carcinoma associated with thyrotoxicosis. Thyroid. 1999;9:13-17.

55. Nikiforova MN, Stringer JR, Blough R, et al. Proximity of chromosomal loci that participate in radiation-induced rearrangements in human cells. Science. 2000;290:138-141.

56. Santoro M, Thomas GA, Vecchio G, et al. Gene rearrangement and Chernobyl related thyroid cancers. Br J Cancer. 2000;82:315-322.

57. Kroll TG, Sarraf P, Pecciarini L, et al. PAX8-PPARgamma1 fusion oncogene in human thyroid carcinoma [corrected]. Science. 2000;289:1357-1360.

58. Marques AR, Espadinha C, Catarino AL, et al. Expression of PAX8- PPAR ã1 rearrangements in both follicular thyroid carcinomas and adenomas. J Clin Endocrinol Metab. 2002;87:3947-3952.

59. Nikiforova MN, Biddinger PW, Caudill CM, et al. PAX8-PPAR ã rearrangement in thyroid tumors: RT-PCR and immunohistochemical analyses. Am J Surg Pathol. 2002;26:1016-1023.

60. Davies H, Bignell GR, Cox C, et al. Mutations of the BRAF gene in human cancer. Nature. 2002;417:949-954.


Usted debe ingresar al sitio con su cuenta de usuario IntraMed para ver los comentarios de sus colegas o para expresar su opinión. Si ya tiene una cuenta IntraMed o desea registrase, ingrese aquí

Contenidos relacionados
Los editores le recomiendan continuar con las siguientes lecturas: