Skip to main content
SpringerLink
Log in

Limitations of thyroid scanning in solitary thyroid nodules

  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Summary

During an 8-year period, 104 patients (19 males, 85 females) underwent surgery for a solitary thyroid nodule. There were 19 (18.3%) malignant nodules and 85 (81.7%) benign nodules. Malignancy occurred in 3 (15.8%) males and 16 (18.8%) females. Pre-operative scanning was performed prior to referral in 59 patients (52 had ultrasound, 41 had isotope scanning; the majority had both). Of the scanned patients, 12 (20%) had a malignant nodule while 7 (15.5%) of the 45 patients who did not have scanning had a malignant nodule. In patients who had an ultrasound scan, malignancy was found in 5 (23.8%) of the 21 solid nodules and 7 (22.7%) of the 31 cystic (or solid/cystic) nodules. In patients who had thyroid isotope scanning, malignancy was found in 6 (17.5%) of the 34 cold (non-functioning) nodules and 3 (43%) of the 7 warm or hot (functioning) nodules. Ultrasound and isotope scanning may be misleading and neither help to differentiate benign from malignant thyroid nodules which require surgical excision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ashcraft, M. W., Van Herle, A. J. Management of thyroid nodules I: history and physical examination, blood tests, x-ray tests and ultrasonography. Head Neck Surg. 1981; 3: 216–30.

    Article  PubMed  CAS  Google Scholar 

  2. Crile, G. Treatment of thyroid cysts by aspiration. Surgery 1966; 59: 210–12.

    PubMed  Google Scholar 

  3. Rosen, I. B., Walfish, P. G., Muskin, M. The application of ultrasound to the study of thyroid enlargement: Management of 450 cases. Arch Surg. 1975; 110: 940–4.

    PubMed  CAS  Google Scholar 

  4. Ashcraft, M. W., Van Herle, A. J. Management of thyroid nodules II: scanning techniques, thyroid suppressive therapy and fine needle aspiration. Head Neck Surg. 1981; 3: 297–322.

    Article  PubMed  CAS  Google Scholar 

  5. Shulkin, B. L., Shapiro, B. The role of imaging tests in the diagnosis of thyroid carcinoma. Clin. Endocrinol. Metab. North Am. 1990; 19: 53–63.

    Google Scholar 

  6. Rojeski, M. T., Gharib, H. Nodular thyroid disease. N. Engl. J. Med 1985; 313: 428–36.

    PubMed  CAS  Google Scholar 

  7. Anderson, J. B., Webb, A. J. Fine-needle aspiration biopsy and the diagnosis of thyroid cancer. Br. J. Surg. 1987; 74: 292–6.

    Article  PubMed  CAS  Google Scholar 

  8. Cusick, E. L., Mclntosh, C. A., Kruwowski, Z. H., Matheson, N. A. Cystic change and neoplasia in isolated thyroid swellings. Br. J. Surg. 1988; 75: 982–3.

    Article  PubMed  CAS  Google Scholar 

  9. Evans, D. M. Diagnostic discriminants of thyroid cancer. Am. J. Surg. 1987; 153: 569–70.

    Article  PubMed  CAS  Google Scholar 

  10. Hammer, M., Wortsman, J., Folse, R. Cancer in cystic lesions of the thyroid. Arch. Surg. 1982; 117: 1020–3.

    PubMed  CAS  Google Scholar 

  11. Block, M. A. Surgery of thyroid nodules and malignancy. Curr. Probl. Surg. 1983; 20: 133–203.

    Article  PubMed  CAS  Google Scholar 

  12. Rosen, I. B., Wallace, C., Strawbridge, H. G., Walfish, P. G. Re-evaluation of needle aspiration cytology in detection of thyroid cancer. Surgery 1981; 90: 947–55.

    Google Scholar 

  13. Cox, M. R., Marshall, S. G., Spence, R. A. J. Solitary thyroid nodule: a prospective evaluation of nuclear scanning and ultrasonography. Br. J. Surg. 1991; 78: 90–3.

    Article  PubMed  CAS  Google Scholar 

  14. Gharibh, H., Goellner, J. R. Evaluation of nodular thyroid disease. Clin. Endocrin. Metab. North Am. 1988; 17: 511–26.

    Google Scholar 

  15. Brooks, J. R., Starnes, H. F., Brooks, D. C., Pelkey, J. N. Surgical therapy for thyroid carcinoma: a review of 1249 solitary thyroid nodules. Surgery 1988; 104: 940–5.

    PubMed  CAS  Google Scholar 

  16. Psarras, A., Papadopoulus, S. N., Livadas, D., Pharmakiotos, A. D., Koutas, D. A. The single thyroid nodule. Br. J. Surg. 1967; 59: 545.

    Article  Google Scholar 

  17. Hoffman, G. L., Thompson, N. W., Heffron, C. The solitary thyroid nodule. A reassessment. Arch. Surg. 1972; 105: 379–85.

    Google Scholar 

  18. Gharibh, H., Goellner, J. R., Zinsmeister, A. R., Grant, C. S., Van Heerden, J. A. Fine needle aspiration biopsy of the thyroid. The problem of suspicious cytologic findings. Ann. Intern. Med. 1984; 101: 25–28.

    Google Scholar 

  19. Saxe, A. W. Thyroid scans and the diagnosis of carcinoma of the thyroid. Surg. Gyn. Obs. 1979; 149: 729–30.

    CAS  Google Scholar 

  20. Harsoulis, P., Leontsini, M., Economou, A., Gerasimidas, T., Smbarounis, C. Fine needle aspiration biopsy cytology in the diagnosis of thyroid cancer: comparative study of 213 operated patients. Br. J. Surg. 1986; 73: 461–4.

    Article  PubMed  CAS  Google Scholar 

  21. Esselstyn, C. B., Crile, G. Evaluation of various types of needle biopsies of the thyroid. World J. Surg. 1984; 8: 452–7.

    Article  PubMed  Google Scholar 

  22. Esselstyn, C. B., Crile, G. Needle aspiration and needle biopsy of the thyroid. World J. Surg. 1978; 2: 321–9.

    Article  PubMed  Google Scholar 

  23. Lowenhagen, T., Granberg, P. O., Lundell, G. Aspiration biopsy cytology (ABC) in tumours of the thyroid gland suspected to be malignant. Surg. Clin. North Am. 1979; 59: 3.

    Google Scholar 

  24. Lowenhagen, T., Willems, J.-S., Lundell, G., Sundblad, R., Granbert, P. Aspiration biopsy cytology in diagnosis of thyroid cancer. World J. Surg. 1981; 5: 61–73.

    Article  Google Scholar 

  25. Lennquist, S. The thyroid nodule. Diagnosis and treatment. Surg. Clin. North Am. 1987; 67: 213–32.

    PubMed  CAS  Google Scholar 

  26. Nishiyama, R. H., Bigos, S. T., Goldfarb, W. B., Flynn, S. D., Taxiarchis, L. N. The efficacy of simultaneous fineneedle aspiration and large-needle biopsy of the thyroid gland. Surgery 1986; 100: 1133–7.

    PubMed  CAS  Google Scholar 

  27. Kaplan, M. M. Progress in thyroid cancer. Clin. Endocrin. Metab. North Am. 1990: 19: 469–77.

    CAS  Google Scholar 

  28. Hamburger, J. I., Husain, M. Contribution of intraoperative pathology evulation to surgical management of thyroid nodules. Clin. Endocrin. Metab. North Am. 1990; 19: 509–21.

    CAS  Google Scholar 

  29. McCall, A., Jarosz, H., Lawrence, A. M., Paloyan, E. The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goitres. Surgery 1986; 100: 1128–31.

    PubMed  CAS  Google Scholar 

  30. Shaw, J. H. F., Dodds, S. P. Carcinoma of the thyroid gland in Auckland, New Zealand. Surg. Gyn. Obs. 1990; 171: 27–32.

    CAS  Google Scholar 

  31. Lahey, F. H., Hare, H. F. Malignancy in adenomas of the thyroid. JAMA 1951; 145: 689–95.

    CAS  Google Scholar 

  32. Pigott, J. D., Braund, R. R. The thyroid nodule and thyroid cancer. Southern Med. J. 1963; 56: 534.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Department of Surgery, Regional Hospital, Wilton, Cork

    B. Kneafsey, P. Gillen & M. P. Brady

Authors
  1. B. Kneafsey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Gillen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. P. Brady
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kneafsey, B., Gillen, P. & Brady, M.P. Limitations of thyroid scanning in solitary thyroid nodules. I.J.M.S. 163, 451–454 (1994). https://doi.org/10.1007/BF02940564

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02940564

Keywords

Search

Navigation