J Korean Soc Endocrinol.  2002 Oct;17(5):649-656.

Clinical and Ultrasonographic Characteristics of Malignant Thyroid Incidentalomas

• Kang HW
• Kim KW
• Lee BW
• Kang BH
• Kim HH
• Kim BJ
• Chung JH
• Min YK
• Lee MS
• Lee MK

Abstract

BACKGROUND: High-resolution ultrasonography has made the detection of asymptomatic small thyroid possible. Recent increases in the detection of incidentalomas have created a clinical dilemma on how to properly manage such incidental nodules. We investigated the prevalence, clinical and ultrasonographic characteristics, and optimal diagnostic approach toward incidentally detected benign and malignant thyroid nodules of less than 1.5 cm in size.
METHODS
A retrospective review was undertaken on the 1,475 patients who had visited Samsung Medical Center, Seoul Korea between January 1999 and December 2000. The review consisted of a physical examination of the thyroid gland, thyroid function test, antithyroid antibodies, thyroid ultrasonography, fine-needle aspiration biopsy, pathology and TNM staging of the incidentally detected thyroid nodules of less than 1.5 cm in size.
RESULTS
The prevalence of thyroid incidentalomas was 13.4% and the malignancy rate within them was 28.8%. There were no significant differences in age, sex, thyroid function test and size between the benign and malignant incidentalomas. Ultrasonographic characteristics showed meaningful diagnostic value for the detection of malignancy in incidentalomas. Most malignant incidentalomas were of a low stage.
CONCLUSION
Occult thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodules less than 1.5 cm ; however, ultrasonographic fingings can be used to decision of optimal management strategies.

MeSH Terms

Antibodies
Biopsy, Fine-Needle
Humans
Korea
Neoplasm Staging
Pathology
Physical Examination
Pregnancy
Prevalence
Retrospective Studies
Seoul
Thyroid Function Tests
Thyroid Gland*
Thyroid Nodule
Ultrasonography
Antibodies