Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Gr...

/pdf/2015-american-thyroid-association-management-guidelines-for-32kri8vrhd.pdf

2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

Understanding secular trends of thyroid cancer is critical to plan strategies for cancer prevention and control. Our aim was to estimate the incidence and mortality trends of thyroid cancer in China during 2005–2015. A retrospective cohort evaluation of thyroid cancer cases and deaths during 2005–2015 was performed using population-based data from the Chinese Cancer Registry Annual Report. The incidence and mortality rates of thyroid cancer were stratified by gender, age group (0, 1–4, 5–9, 10–14…80–84, 85–), and area (urban or rural). A Joinpoint regression model was used to examine secular trends. In China, the age-standardized incidence was 3.21/105 in 2005, and increased to 9.61/105 in 2015. Besides, a significant increase incidence rate was observed with the average annual percent change (AAPC) of 12.4% (95% CI: 10.5%–14.4%) in the period 2005–2015. The age-standardized mortality was 0.30/105 in 2005 and 0.35/105 in 2015, and the AAPC was 2.9% (95% CI: 1.3%–4.5%). For both incidence and mortality, the rates of thyroid cancer were much higher in females than in males, and in urban areas rather than rural areas; however, the rates of increasing trends showed no significant differences. With respect to the highest age-specific rates, it appeared in the age group of 50–54 years old for incidence and in the age group of 80–84 years old for mortality. Notably, the rate of increasing incidence trend was lower in older age groups, especially for people aged 70–79 years old. A rapid increase in incidence and a moderate increase in mortality of thyroid cancer were observed from 2005 to 2015 in our study. Effective measures and tailored programs should be taken to curb the growth trend and reduce the disease burden.

Thyroid cancer: incidence and mortality trends in China, 2005–2015

Thyroid nodules are less frequent in children than adults. Childhood thyroid nodules carry specific features, including a higher risk of malignancy than nodules in adults, rendering them unique in terms of management. Subsequently, they should be considered a distinct clinical entity with specific imaging recommendations. Initial evaluation requires a thorough workup, including clinical examination, and a detailed personal and familial history to determine the presence of possible risk factors. Laboratory and radiologic evaluation play an integral part in the diagnostic algorithm, with ultrasonography (US) being the first diagnostic test in all patients. US elastography has been recently introduced as an incremental method, reducing the subjectivity of the clinical diagnosis of nodule firmness associated with increased malignancy risk. However, fine-needle aspiration biopsy (FNAB) remains the mainstay in the diagnostic work-up of thyroid nodules and is documented to be best method for differentiating benign from malignant thyroid nodules. In addition, thyroid scintigraphy provides functional imaging information, which has a role both in the diagnostic management of thyroid nodules and during follow up in malignancies. Finally, despite providing additional information in certain clinical scenarios, 18F-fludeoxyglucose Positron Emission Tomography (18F-FDG-PET), computed tomography (CT), and magnetic resonance imaging (MRI) imaging are not routinely recommended for the evaluation of patients with newly detected thyroid nodules or in all cases of thyroid cancer. The objective of this review is to summarize the concepts in imaging and imaging-based management of nodular thyroid disease in the pediatric population, acknowledging the unique features that this patient group carries and the specific approach it requires.

https://www.mdpi.com/2077-0383/9/2/384/pdf

Imaging and Imaging-Based Management of Pediatric Thyroid Nodules.

Background: The expanding use of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) has led to the identification of increasing numbers of patients with an incidentaloma in the thyroid gland. We aimed to review the proportion of incidental thyroid cancers found by 18F-FDG PET or PET/computed tomography imaging. Methods: Studies evaluating thyroid carcinomas discovered incidentally in patients or healthy volunteers by 18F-FDG PET were systematically searched in the PubMed database from 2000 to 2011. The main exclusion criteria were known thyroid disease, lack of assigned diagnoses, investigation of diffuse uptake only, or investigation of patients with head and neck cancer, or cancer in the upper part of the thorax. Results: Twenty-two studies met our criteria comprising a total of 125,754 subjects. Of these, 1994 (1.6%) had unexpected focal hypermetabolic activity, while 999 of 48,644 individuals (2.1%) had an unexpected diffuse hypermetabolic activity in the thyroid gland. A diagnosis was ...

Risk of malignancy in thyroid incidentalomas detected by 18F-fluorodeoxyglucose positron emission tomography. A systematic review

Pediatric differentiated thyroid carcinoma: An update from the APSA Cancer Committee.

Purpose of reviewThe review is focused on new information about the presentation and management of thyroid nodules in children and adolescents.Recent findingsPalpable thyroid nodules are uncommon in children but many children have nodules detected by radiologic imaging. How to evaluate them, when to

Evaluation and management of thyroid nodules in children

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Evaluation and management of thyroid nodules in children