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Further evaluation with ultrasound is required for patients less than 35 years old with nodules measuring more than 1 cm in the axial plane. The cutoff size for further evaluation is raised to 1.5 cm for patients more than 35 years old. This recommendation should be applied to the largest thyroid nodule in cases of multiple thyroid nodules.
If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10] Ultrasound has a sensitivity of 64-77% and a specificity of 82-90% for the detection of thyroid cancer. [10]
Other clinical signs that could indicate papillary thyroid are fixation to the trachea, a firm neck mass, damage to recurrent laryngeal or cervical sympathetic nerves. Five percent of the population can have thyroid nodules, and the majority will be benign. [6] Appropriate workup includes an ultrasound of the neck, followed by lab studies.
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2 ...
Solitary thyroid nodules are more common in females yet more worrisome in males. Other associations with neoplastic nodules are family history of thyroid cancer and prior radiation to the head and neck. Solitary thyroid nodules are mostly benign colloid nodules. The second most common type is follicular adenoma. [26]
Ultrasound can ablate tumors or other tissue non-invasively. [4] This is accomplished using a technique known as high intensity focused ultrasound (HIFU), also called focused ultrasound surgery. This procedure uses generally lower frequencies than medical diagnostic ultrasound (250–2000 kHz), but significantly higher time-averaged intensities.
Low uptake suggests thyroiditis, high uptake suggests Graves' disease, [5] and unevenness in uptake suggests the presence of a nodule. [citation needed] 123 I has a shorter half-life than 131 I (a half day vs. 8.1 days), so use of 123 I exposes the body to less radiation, at the expense of less time to evaluate delayed scan images. [6]
Anaplastic thyroid cancer seen on an ultrasound image Anaplastic thyroid carcinoma cells. ATC is considered an emergency cancer diagnosis since it poses a high risk of blocking the airway and/or esophagus due to its rapid growth in the neck, either of which can quickly cause a person's death by asphyxiation, if not immediately corrected. [2]