González Treviño O, Bolaños Gil F, Lerman Garber I, García-Rubí E, Maisterrena Fernández J A
Clínica de Tiroides, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Rev Invest Clin. 1993 Jan-Feb;45(1):57-66.
We present a prospective study of 88 patients with thyroid nodules seen in our institution in 1985-86 and the results of a 5 year follow up. The algorithm for resolution among different therapeutic options was established in regard to the clinical characteristics, imaging and particularly the histopathologic studies. Their age ranged from 18 to 79 years; 94% of the patients were females. Most of the nodules were solid (69%) and measured 1-4 cm in diameter. The image of 62% of the thyroid scans was of a non-functioning nodule and 13% were hyperfunctioning. In 80% the ultrasonographic pattern was solid or mixed. Surgery was undertaken in 19 patients (21%). In 58%, a diagnosis of malignancy was established. The biopsy (aspiration and tru-cut) suggested the presence of the malignant tumors when taken together in 90% of the cases. Hormonal treatment was given to 62 patients; in 40-45% of them there was a significant reduction in the size of the nodule. Aspiration and sclerosis of cystic nodules were performed in 19 patients with significant shrinkage in 82%. Radioactive iodine was used in 11 patients. Our algorithm reduces costs and precludes unnecessary morbidity in patients with thyroid nodules.