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Deutsches Arzteblatt International Jul 2012Thyroid enlargement and thyroid nodules are common in the general population. This review concerns their proper diagnostic assessment and treatment. (Review)
Review
BACKGROUND
Thyroid enlargement and thyroid nodules are common in the general population. This review concerns their proper diagnostic assessment and treatment.
METHODS
We selectively reviewed the literature from 1990 to 2012 and evaluated original articles and reviews retrieved from the PubMed database, as well as the recommendations of the following specialty societies: the German Societies of Endocrinology and Nuclear Medicine (Deutsche Gesellschaft für Endokrinologie, Deutsche Gesellschaft für Nuklearmedizin), the German Working Group for Endocrine Surgery (Chirurgische Arbeitsgemeinschaft Endokrinologie, CAEK), the European Thyroid Association, and the American Thyroid Association.
RESULTS
There have been very few randomized trials concerning the diagnosis and treatment of goiter. Nodular goiter can be managed by watchful waiting, drug treatment (initially with levothyroxine and iodide), radioactive iodine therapy, or surgery.
CONCLUSION
Many patients with nodules need no treatment at all. Treatment is indicated, however, if the patient is symptomatic and/or has an autonomously functioning ("hot") nodule, or if cancer is suspected. Potentially cancerous nodules must be operated on. If euthyroid nodular goiter is to be treated with the main goal of size reduction, either surgery or radioactive iodine therapy can be used. Drug treatment is an option for small nodules or goiters, but iatrogenic hyperthyroidism must be avoided at all costs. The type of follow-up that is required depends on the chosen treatment.
Topics: Goiter, Nodular; Humans; Thyroid Neoplasms; Thyroid Nodule
PubMed: 23008749
DOI: 10.3238/arztebl.2012.0506 -
Medical Principles and Practice :... 2020There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases... (Review)
Review
There is an increased incidence of thyroid nodules and cancer. In this article, the reasons for this increase are evaluated and discussed. The factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. The literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. Of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.
Topics: Goiter, Nodular; Humans; Iodine; Risk Factors; Thyroid Neoplasms; Thyrotropin
PubMed: 31542786
DOI: 10.1159/000503575 -
Clinical Medicine (London, England) Jun 2017Graves' disease (GD) and toxic nodular (TN) goitre account for most cases of thyrotoxicosis associated with hyperthyroidism. Hyperthyroidism is confirmed with... (Review)
Review
Graves' disease (GD) and toxic nodular (TN) goitre account for most cases of thyrotoxicosis associated with hyperthyroidism. Hyperthyroidism is confirmed with measurement of a suppressed serum thyrotropin concentration (TSH) and elevated free thyroid hormones. The three therapeutic options are antithyroid drugs, radioactive iodine and surgery. Thionamides achieve long-term remission in 35% of cases. Many centres administer fixed doses of iodine-131; larger doses result in improved rates of cure at the cost of hypothyroidism. Surgery is usually considered for patients who have a large goitre, compressive symptoms or significant ophthalmopathy.
Topics: Antithyroid Agents; Goiter, Nodular; Graves Disease; Humans; Iodine Radioisotopes; Thyrotoxicosis
PubMed: 28572231
DOI: 10.7861/clinmedicine.17-3-274 -
Deutsches Arzteblatt International Jan 2018Thyroidectomy is still three to six times more common in Germany than in the USA, Great Britain, and the Scandinavian countries. Thus, the question is often asked... (Review)
Review
BACKGROUND
Thyroidectomy is still three to six times more common in Germany than in the USA, Great Britain, and the Scandinavian countries. Thus, the question is often asked whether thyroidectomy in Germany is being performed for the correct indications.
METHODS
This review is based on studies and guidelines containing information on the indications for surgery in benign goiter and Graves' disease; these publications were retrieved by a systematic literature search in the Medline and Cochrane Library databases (1990-2016). The indications recommended here were determined by vote by the German Society for General and Visceral Surgery (Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, DGAV).
RESULTS
On the basis of the available evidence (levels 2-4), and in the absence of prospective studies, the indications for surgery in goiter include a well-founded suspicion of malignancy, local compressive symptoms, and, rarely, cosmesis. In hyperthyroid goiter and Graves' disease, surgery is a potential alternative to radio - iodine therapy, particularly if the volume of the thyroid gland exceeds 80 mL, in patients with advanced or active orbitopathy, and in female patients who are, or plan to be, pregnant. Large, asymptomatic, euthyroid nodular goiter without any suspicion of malignancy and scintigraphically "cold" nodules without any other evidence of malignancy are not indications for surgery. Thyroid operations of higher levels of difficulty (e.g., recurrent goiter, retrosternal extension, Graves' disease) should be carried out in institutions with special expertise in thyroid surgery.
CONCLUSION
The decision to operate should be made on an interdisciplinary basis and in conformity with the relevant guidelines after all of the appropriate diagnostic studies have been performed. The radicality of any proposed surgical procedure should be weighed against its potential complications.
Topics: Adult; Female; Goiter, Nodular; Graves Disease; Humans; Prospective Studies; Thyroidectomy
PubMed: 29345225
DOI: 10.3238/arztebl.2018.0001 -
Journal of the National Medical... Jul 2005Graves' disease and toxic nodular goiter both cause thyrotoxicosis by different pathophysiological mechanisms. Cases with both etiologies have the diagnosis of...
Graves' disease and toxic nodular goiter both cause thyrotoxicosis by different pathophysiological mechanisms. Cases with both etiologies have the diagnosis of Marine-Lenhart syndrome. Such a case is presented in this paper.
Topics: Diagnosis, Differential; Female; Goiter, Nodular; Graves Disease; Humans; Hyperthyroidism; Middle Aged; Syndrome; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule; Thyrotoxicosis
PubMed: 16080676
DOI: No ID Found -
Deutsches Arzteblatt International Mar 2018
Topics: Calcitonin; Goiter, Nodular; Humans
PubMed: 29669680
DOI: 10.3238/arztebl.2018.0221b -
Medicine Jun 2022Katanin subunits p60 and p80 are involved in microtubule-mediated cytoskeletal organization during cell division. Their aberrant expression has been found in prostate,...
Katanin subunits p60 and p80 are involved in microtubule-mediated cytoskeletal organization during cell division. Their aberrant expression has been found in prostate, breast, and non-small cell lung (NSCLC) cancers. It has recently been reported that compared with adjacent papillary thyroid carcinoma (PTC) tissues, both are highly expressed in tumor tissues. Here, we investigated whether katanin subunits p60 and p80 can be used as potential biomarkers for PTC to distinguish nodular goiter (NG).Immunohistochemistry was performed to investigate the expression of katanin subunits p60 and p80 in the tissues of 97 cases of PTC and NG. This cohort included 87 cases with PTC (74 classical or conventional (CPTC) and 13 follicular (FVPTC) variants) and 10 cases with NG.We found that katanin subunits p60 and p80 were expressed in PTC, but not in NG. The cutoff values of katanin p60 and p80 for PTC were 22.43% and 0.83%, respectively. The katanin subunit p60 was significantly associated with lymph node metastasis. Katanin subunit p80 was more highly expressed in CPTC than in FVPTC. The expression of the katanin subunit p60 was positively correlated with the expression of katanin p80 in PTC. Importantly, we found that overexpression of katanin p60 increased the expression of katanin p80 in a human papillary thyroid carcinoma KTC-1 cell line, which further supports the existence of katanin p60 and p80 feedback loops.Our results indicate that katanin subunits p60 and p80 may be used as potential PTC biomarkers to distinguish NG and may be novel therapeutic targets for PTC.
Topics: Adenosine Triphosphatases; Biomarkers; Goiter, Nodular; Humans; Katanin; Male; Thyroid Cancer, Papillary; Thyroid Neoplasms
PubMed: 35713446
DOI: 10.1097/MD.0000000000029402 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =...Hyperfunctioning parathyroid lesions require surgical resection. Tc-methoxyisobutylisonitrile (Tc-MIBI) single-photon emission computed tomography/computed tomography...
OBJECTIVES
Hyperfunctioning parathyroid lesions require surgical resection. Tc-methoxyisobutylisonitrile (Tc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) plays an important role in the diagnosis of parathyroid lesions. Some nodular goiters have a higher uptake of Tc-MIBI, which is difficult to distinguish from hyperfunctioning parathyroid lesions. This study aims to explore the value of Tc-MIBI SPECT/CT in the differential diagnosis of parathyroid lesions and nodular goiter.
METHODS
This study was a retrospective analysis. A total of 68 patients who were diagnosed as parathyroid lesions by Tc-MIBI SPECT/CT were enrolled, with a total of 81 lesions. According to the results of pathological examination after surgical resection, the lesions were divided into a parathyroid lesion group (=69) and a nodular goiter group (=12). The target maximum radioactivity count (Tmax) of all lesions was measured. The mean radioactivity count of the aortic arch was used as the background mean radioactivity count (Bmean), and the ratio of the Tmax to Bmean was calculated. The difference in Tmax/Bmean between the 2 groups was compared. The minimum, mean, and maximum of CT density in the lesion were measured. The difference of CT density between the 2 groups was compared. The receiver operating characteristic (ROC) curve of patients with parathyroid lesions and patients with nodular goiter was drawn, and the diagnostic efficacy of each CT density value was evaluated.
RESULTS
The Tc-MIBI radioactive uptake in parathyroid lesions and nodular goiter lesions was significantly concentrated. The CT density values of the 2 lesions were lower than normal thyroid tissue, and the boundary between the 2 lesions and the thyroid was clear or blurred. There was no significant difference in Tmax/Bmean between the 2 groups (=0.221). The differences in the minimum, mean and maximum of CT density between the 2 groups were statistically significant (all <0.05). The diagnostic efficiency of maximum of CT density was the best, area under the ROC curve was 0.894 (<0.001), the cut-off was 91 HU, the sensitivity was 83.3%, and the specificity was 94.2%.
CONCLUSIONS
The degree of Tc-MIBI radiation uptake in the focus has limited value in differentiating parathyroid lesions from nodular goiter, and the maximum density of CT possesses high diagnostic efficiency.
Topics: Goiter, Nodular; Humans; Parathyroid Glands; Radiopharmaceuticals; Retrospective Studies; Single Photon Emission Computed Tomography Computed Tomography; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon
PubMed: 34707013
DOI: 10.11817/j.issn.1672-7347.2021.190641 -
Environmental Health : a Global Access... Jan 2022The incidence rates of thyroid tumors and nodular goiter show an upward trend worldwide. There are limited reports on the risk of perchlorate and iodine on thyroid...
BACKGROUND
The incidence rates of thyroid tumors and nodular goiter show an upward trend worldwide. There are limited reports on the risk of perchlorate and iodine on thyroid tumors, but evidence from population studies is scarce, and their impact on thyroid function is still uncertain. Therefore, the objective of this study was to investigate the association of perchlorate and iodine with the risk of nodular goiter (NG), papillary thyroid microcarcinoma (PTMC), and papillary thyroid carcinoma (PTC) and to assess the correlation between perchlorate and iodine with thyroid function indicators.
METHODS
A case-control population consisting of 184 pairs of thyroid tumors and nodular goiter matched by gender and age (±2 years) was recruited in this study. Serum and urine samples were collected from each participant. Thyroid function indicators in serum were tested by automatic chemical immunofluorescence, and perchlorate and iodine levels in urine were determined by ultra-high performance liquid chromatography tandem-mass spectrometry and inductively coupled plasma-mass spectrometry, respectively. Conditional logistic regressions and multiple linear regressions were used to analyze the associations.
RESULTS
Urinary perchlorate concentration was significantly higher in total cases, NG and PTC than in the corresponding controls (P < 0.05). Perchlorate was positively associated with PTC (OR = 1.058, 95% CI: 1.009, 1.110) in a non-linear dose-response relationship, but there was no association between perchlorate and NG or PTMC. Iodine was not associated with the risk of thyroid tumors and NG and did not correlate with the thyroid function indicators. Furthermore, perchlorate showed a positive correlation with thyroid stimulating hormone (TSH) at iodine adequate levels (P < 0.05), and a negative correlation with free triiodothyronine (FT3) and a positive correlation with thyroglobulin antibody (TgAb) at iodine more than adequate or excess levels (P < 0.05).
CONCLUSIONS
Perchlorate can increase the risk of PTC in a non-linear dose-response relationship and disturb the thyroid hormone homeostasis and thyroid autoantibody levels.
Topics: Case-Control Studies; China; Goiter, Nodular; Humans; Incidence; Iodine; Perchlorates; Thyroid Neoplasms; Thyrotropin
PubMed: 34980104
DOI: 10.1186/s12940-021-00818-8 -
PloS One 2022The goiter, a neglected heterogeneous molecular disease, remains a major indication for thyroidectomies in its endemic regions.
INTRODUCTION
The goiter, a neglected heterogeneous molecular disease, remains a major indication for thyroidectomies in its endemic regions.
OBJECTIVES
This study analyzed differential gene expression in surgical specimens diagnosed with multi nodular and compared the data to that of thyroid tissue without multinodular goiter from patients undergoing thyroidectomy in Manaus-AM, Brazil using RNA-seq technology.
METHODOLOGY
The transcriptome information of the surgical specimen fragments with and without multinodular goiter was accessed by Illumina HiSeq 2000 New Generation Sequencing (NGS) using the RNA-seq NEBNext® Ultra™ RNA Library Prep Kit for Illumina®-#E7530L protocol and differential gene expression analysis.
RESULTS
Differences were found between the gene expression profiles of the diseased tissues and those of the healthy control tissues; at least 70 genes were differentially expressed. The HOTS gene was expressed only in multinodular goiter tissues (p < 0.05).
CONCLUSION
These results demonstrate that the gene expression profile of multinodular goiter is pro-tumoral and that HOTS can play a central role in multinodular goiter development.
Topics: Gene Library; Goiter, Nodular; Humans; Thyroidectomy; Transcriptome
PubMed: 35594253
DOI: 10.1371/journal.pone.0268354