Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Eur Arch Otorhinolaryngol. 2010 Jul;267(7):1019-26. doi: 10.1007/s00405-010-1207-1. Epub 2010 Feb 13.
Incidental lesions of the thyroid gland are an increasing problem facing clinicians. While asymptomatic palpable lesions are detected in only 4-7% of the population, currently available imaging modalities are sensitive enough to detect lesions in 20-30% of the population. Guidelines for managing these incidentalomas are limited, largely due to lack of well-powered prospective studies. This review will address the currently available data on thyroid incidentalomas, detected through clinical examination, cross-sectional imaging, ultrasound, and PET scans. We will focus on the modalities of detection and risk of malignancy, further investigation and management options and the deficiencies therein. We propose a pragmatic algorithm when faced with this clinical dilemma under differing circumstances.
甲状腺偶发病变是临床医生面临的一个日益严重的问题。虽然无症状可触及的病变仅在人群中占 4-7%，但目前可用的影像学检查方法已经足够灵敏，能在人群中检出 20-30%的病变。管理这些偶发瘤的指南有限，主要是因为缺乏有力的前瞻性研究。本综述将讨论目前通过临床检查、横断面成像、超声和 PET 扫描检测到的甲状腺偶发瘤的相关数据。我们将重点讨论检测方法和恶性肿瘤风险、进一步检查和治疗选择及其存在的缺陷。我们提出了一个实用的算法，用于在不同情况下应对这一临床难题。
