Abstract
The management of an "isofunctioning" thyroid nodule - defined by radioiodine uptake equivalent to normal thyroid tissue - is often a dilemma. Our goal was to determine the percentage of thyroid nodules that were isofunctioning and the frequency with which carcinoma occurred in an isofunctioning nodule. Patients referred for evaluation of a thyroid nodule from 1990 to 2002 were reviewed and those with an iodine-123 thyroid scintiscan were identified. Nodule size, serum thyrotropin, fine-needle aspiration biopsy, pathology, and follow-up were determined for patients with an isofunctioning, hypofunctioning, or hyperfunctioning thyroid nodule. Of the 562 patients with a thyroid nodule 273 (49%) had a thyroid scan. Nodules were hypofunctioning in 232 (85%), isofunctioning in 29 (11%), and hyperfunctioning in 12 (4%) patients. Mean nodule size and serum thyrotropin level were respectively 2.49 ± 0.23 cm and 1.73 ± 0.26 μIU/mL for isofunctioning, 2.47 ± 0.31 cm and 0.83 ± 0.21 μIU/mL for hyperfunctioning, and 3.94 ± 0.13 cm and 1.86 ± 0.28 μIU/mL for hypofunctioning nodules. Seventeen patients with an isofunctioning nodule underwent thyroidectomy and 12 patients were followed for a mean 27 months without an increase in nodule size. No patient with a hyperfunctioning nodule, six patients (21%) with an isofunctioning nodule, and 44 patients (19%) with a hypofunctioning nodule had a carcinoma. We conclude that the risk of malignancy in an isofunctioning nodule is similar to that of a hypofunctioning nodule and therefore the management should be based on routine fine-needle aspiration biopsy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 311-315 |
| Number of pages | 5 |
| Journal | American Surgeon |
| Volume | 69 |
| Issue number | 4 |
| State | Published - 2003 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
Cite this
The clinical significance of an isofunctioning thyroid nodule. / Hedayati, Nasim; McHenry, Christopher R.
In: American Surgeon, Vol. 69, No. 4, 2003, p. 311-315.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The clinical significance of an isofunctioning thyroid nodule
AU - Hedayati, Nasim
AU - McHenry, Christopher R.
PY - 2003
Y1 - 2003
N2 - The management of an "isofunctioning" thyroid nodule - defined by radioiodine uptake equivalent to normal thyroid tissue - is often a dilemma. Our goal was to determine the percentage of thyroid nodules that were isofunctioning and the frequency with which carcinoma occurred in an isofunctioning nodule. Patients referred for evaluation of a thyroid nodule from 1990 to 2002 were reviewed and those with an iodine-123 thyroid scintiscan were identified. Nodule size, serum thyrotropin, fine-needle aspiration biopsy, pathology, and follow-up were determined for patients with an isofunctioning, hypofunctioning, or hyperfunctioning thyroid nodule. Of the 562 patients with a thyroid nodule 273 (49%) had a thyroid scan. Nodules were hypofunctioning in 232 (85%), isofunctioning in 29 (11%), and hyperfunctioning in 12 (4%) patients. Mean nodule size and serum thyrotropin level were respectively 2.49 ± 0.23 cm and 1.73 ± 0.26 μIU/mL for isofunctioning, 2.47 ± 0.31 cm and 0.83 ± 0.21 μIU/mL for hyperfunctioning, and 3.94 ± 0.13 cm and 1.86 ± 0.28 μIU/mL for hypofunctioning nodules. Seventeen patients with an isofunctioning nodule underwent thyroidectomy and 12 patients were followed for a mean 27 months without an increase in nodule size. No patient with a hyperfunctioning nodule, six patients (21%) with an isofunctioning nodule, and 44 patients (19%) with a hypofunctioning nodule had a carcinoma. We conclude that the risk of malignancy in an isofunctioning nodule is similar to that of a hypofunctioning nodule and therefore the management should be based on routine fine-needle aspiration biopsy.
AB - The management of an "isofunctioning" thyroid nodule - defined by radioiodine uptake equivalent to normal thyroid tissue - is often a dilemma. Our goal was to determine the percentage of thyroid nodules that were isofunctioning and the frequency with which carcinoma occurred in an isofunctioning nodule. Patients referred for evaluation of a thyroid nodule from 1990 to 2002 were reviewed and those with an iodine-123 thyroid scintiscan were identified. Nodule size, serum thyrotropin, fine-needle aspiration biopsy, pathology, and follow-up were determined for patients with an isofunctioning, hypofunctioning, or hyperfunctioning thyroid nodule. Of the 562 patients with a thyroid nodule 273 (49%) had a thyroid scan. Nodules were hypofunctioning in 232 (85%), isofunctioning in 29 (11%), and hyperfunctioning in 12 (4%) patients. Mean nodule size and serum thyrotropin level were respectively 2.49 ± 0.23 cm and 1.73 ± 0.26 μIU/mL for isofunctioning, 2.47 ± 0.31 cm and 0.83 ± 0.21 μIU/mL for hyperfunctioning, and 3.94 ± 0.13 cm and 1.86 ± 0.28 μIU/mL for hypofunctioning nodules. Seventeen patients with an isofunctioning nodule underwent thyroidectomy and 12 patients were followed for a mean 27 months without an increase in nodule size. No patient with a hyperfunctioning nodule, six patients (21%) with an isofunctioning nodule, and 44 patients (19%) with a hypofunctioning nodule had a carcinoma. We conclude that the risk of malignancy in an isofunctioning nodule is similar to that of a hypofunctioning nodule and therefore the management should be based on routine fine-needle aspiration biopsy.
UR - http://www.scopus.com/inward/record.url?scp=0038653528&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038653528&partnerID=8YFLogxK
M3 - Article
VL - 69
SP - 311
EP - 315
JO - American Surgeon
JF - American Surgeon
SN - 0003-1348
IS - 4
ER -