Risk of Malignancy in Thyroid Nodules 4 cm or Larger
BackgroundSeveral authors have questioned the accuracy of fine-needle aspiration cytology (FNAC) in large nodules. Some surgeons recommend thyroidectomy for nodules ≥4 cm even in the setting of benign FNAC, due to increased risk of malignancy and increased false negative rates in large thyroid nodul...
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doaj-4c95ba36e1244e409c156036d82e30122020-11-24T22:33:26ZengAcademya Publishing Co.Endocrinology and Metabolism2093-596X2093-59782017-02-01321778210.3803/EnM.2017.32.1.77Risk of Malignancy in Thyroid Nodules 4 cm or LargerUchechukwu C. Megwalu0Department of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.BackgroundSeveral authors have questioned the accuracy of fine-needle aspiration cytology (FNAC) in large nodules. Some surgeons recommend thyroidectomy for nodules ≥4 cm even in the setting of benign FNAC, due to increased risk of malignancy and increased false negative rates in large thyroid nodules. The goal of our study was to evaluate if thyroid nodule size is associated with risk of malignancy, and to evaluate the false negative rate of FNAC for thyroid nodules ≥4 cm in our patient population.MethodsThis is a retrospective study of 85 patients with 101 thyroid nodules, who underwent thyroidectomy for thyroid nodules measuring ≥4 cm.ResultsThe overall risk of malignancy in nodules ≥4 cm was 9.9%. Nodule size was not associated with risk of malignancy (odds ratio, 1.02) after adjusting for nodule consistency, age, and sex (P=0.6). The false negative rate for FNAC was 0%.ConclusionNodule size was not associated with risk of malignancy in nodules ≥4 cm in our patient population. FNAC had a false negative rate of 0. Patients with thyroid nodules ≥4 cm and benign cytology should not automatically undergo thyroidectomy.https://e-enm.org/Synapse/Data/PDFData/2008ENM/enm-32-77.pdfThyroid noduleThyroid neoplasmsBiopsy, fine-needleDiagnostic accuracyLarge nodules |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Uchechukwu C. Megwalu |
spellingShingle |
Uchechukwu C. Megwalu Risk of Malignancy in Thyroid Nodules 4 cm or Larger Endocrinology and Metabolism Thyroid nodule Thyroid neoplasms Biopsy, fine-needle Diagnostic accuracy Large nodules |
author_facet |
Uchechukwu C. Megwalu |
author_sort |
Uchechukwu C. Megwalu |
title |
Risk of Malignancy in Thyroid Nodules 4 cm or Larger |
title_short |
Risk of Malignancy in Thyroid Nodules 4 cm or Larger |
title_full |
Risk of Malignancy in Thyroid Nodules 4 cm or Larger |
title_fullStr |
Risk of Malignancy in Thyroid Nodules 4 cm or Larger |
title_full_unstemmed |
Risk of Malignancy in Thyroid Nodules 4 cm or Larger |
title_sort |
risk of malignancy in thyroid nodules 4 cm or larger |
publisher |
Academya Publishing Co. |
series |
Endocrinology and Metabolism |
issn |
2093-596X 2093-5978 |
publishDate |
2017-02-01 |
description |
BackgroundSeveral authors have questioned the accuracy of fine-needle aspiration cytology (FNAC) in large nodules. Some surgeons recommend thyroidectomy for nodules ≥4 cm even in the setting of benign FNAC, due to increased risk of malignancy and increased false negative rates in large thyroid nodules. The goal of our study was to evaluate if thyroid nodule size is associated with risk of malignancy, and to evaluate the false negative rate of FNAC for thyroid nodules ≥4 cm in our patient population.MethodsThis is a retrospective study of 85 patients with 101 thyroid nodules, who underwent thyroidectomy for thyroid nodules measuring ≥4 cm.ResultsThe overall risk of malignancy in nodules ≥4 cm was 9.9%. Nodule size was not associated with risk of malignancy (odds ratio, 1.02) after adjusting for nodule consistency, age, and sex (P=0.6). The false negative rate for FNAC was 0%.ConclusionNodule size was not associated with risk of malignancy in nodules ≥4 cm in our patient population. FNAC had a false negative rate of 0. Patients with thyroid nodules ≥4 cm and benign cytology should not automatically undergo thyroidectomy. |
topic |
Thyroid nodule Thyroid neoplasms Biopsy, fine-needle Diagnostic accuracy Large nodules |
url |
https://e-enm.org/Synapse/Data/PDFData/2008ENM/enm-32-77.pdf |
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