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Minerva Endocrinologica 2005 June;30(2):59-70

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: Italian

Treatment of patient having thyroid nodules: dimension of disease, diagnostic choices and guide-lines

Pedrazzini L.

The demand of nodule thyroid diagnosis has increased very much in the last years, because of large diffusion of medical information among the population, the increased use and improvement of medical technology that evidences more and more morphology alterations of the gland. The prevalence of palpable thyroid nodule is 2.1-4.2%, but when the ultrasonography is used the prevalence can reach in average 67%. The thyroid cancer however is a rare event: 1% of all malign tumours. The medium incidence is 2.1 for 100000 men per year, and 5.19 for 100000 women per year. pretest illness low probability presents a necessity of a very accurate diagnostic test. The introduction of FNA in the '70 has changed the diagnosis, and allowed to spare time and money. The patient with thyroid nodules should be evaluated by experienced physicians in the thyreopathy field, using efficient remote and family anamnesis, by an accurate palpation of the thyroid and the neck, claiming necessary diagnostic controls. The physician should perform the FNA with a cytopathologist and should convey to him all the clinical and biotumoral information. He should be able to interpret correctly the results of the FNA and to suggest the diagnostic and terapeutical follow-up.
This review reveals the best compromise between cost-effectiveness, based on the evidence results taken from international lecterature, taking into consideration various diagnostic opportunities at our disposal. Guide-lines for the treatment of patients with thyroid nodule are proposed.