Review article

https://doi.org/10.21860/medflum2023_300570

Thyroid Nodule – Diagnostic and Therapeutic Challenge

Ivona Perić orcid.org/0009-0000-9669-1173 ; Klinički bolnički centar Rijeka, Zavod za endokrinologiju, dijabetes i bolesti metabolizma, Rijeka, Hrvatska
Sanja Klobučar orcid.org/0000-0002-0287-4735 ; Klinički bolnički centar Rijeka, Zavod za endokrinologiju, dijabetes i bolesti metabolizma, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Dario Rahelić ; Klinička bolnica Merkur, Sveučilišna klinika za dijabetes, endokrinologiju i bolesti metabolizma Vuk Vrhovac, Zagreb, Hrvatska; Hrvatsko katoličko sveučilište, Medicinski fakultet, Zagreb, Hrvatska; Sveučilište Josipa Jurja Strossmayera u Osijeku, Medicinski fakultet, Osijek, Hrvatska
Jelena Vučak Lončar orcid.org/0000-0002-6983-4922 ; Opća bolnica Zadar, Odjel za endokrinologiju, Zadar, Hrvatska; Sveučilište u Zadru, Odjel za zdravstvene studije, Zadar, Hrvatska
Tatjana Bogović Crnčić orcid.org/0000-0003-4152-7928 ; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska; Klinički bolnički centar Rijeka, Zavod za nuklearnu medicinu, Rijeka, Hrvatska

Abstract

Thyroid cancer, which usually presents as a thyroid nodule, accounts for only 1% of all malignancies, but on the other hand, thyroid nodules are found in more than half of the world’s population. The aforementioned statistics certainly cannot be ignored and therefore a standardized, focused diagnostic and therapeutic approach, which will solve the problem of overdiagnosis without failing to recognize patients who really need medical intervention, is necessary. Upon detection of a nodule in the thyroid gland, the diagnostic process consists of tests that estimate the functional status (hormonal status, scintigraphy), test which reveals the appearance and structure of the thyroid gland and the nodule or nodules (ultrasound), and tests that describe the cellular structure of the nodule and the changes found in the thyroid gland (cytological analysis). The assessment and treatment of these patients is no longer based on a universal, but rather on a personalized approach that advocates a careful and rational evaluation of each lesion within the given clinical context in order to determine as precisely as possible the probability of malignant etiology and to reduce the application of unnecessary diagnostic and therapeutic procedures. The proportion of malignant nodules is small, only 5%, which means that only a small number of nodules in the thyroid gland truly requires intensive evaluation and surgical treatment, while most of the patients have benign nodules which can be treated conservatively after an appropriate initial assassment with frequency of subsequent controls reduced to minimum.

Keywords

Cytology; Thyroid Gland; Thyroid Nodule

Hrčak ID:

300570

URI

https://hrcak.srce.hr/300570

Publication date:

1.6.2023.

Article data in other languages: croatian

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