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Tiroid nodülleri

Year 2016, Volume: 7 Issue: 27, 0 - 0, 30.08.2016
https://doi.org/10.17944/mkutfd.42258

Abstract

Tiroid nodülleri tiroid bezinin sık görülen hastalığıdır. Prevalansı yaşla ve iyot eksikliği ile artmakla birlikte son yıllarda başka nedenlerle yapılan görüntüleme tekniklerinde saptanması farkındalığı da arttırmıştır. Tiroid nodüllerinin tanınıp araştırılmasındaki gereklilik bunların malignite potansiyellerinin olmasıdır. Hastalar genellikle boyunda fark ettikleri şişlik nedeniyle başvururlar. Tiroid fonksiyonları değerlendirilmeli beraberinde ultrasonografi ile nodülün özellikleri (boyutu, sayısı, ekojenitesi, kenar özellikleri, kanlanma düzeni) ortaya konulmalıdır. Nodülün klinik ve morfolojik özelliklerine göre tiroid ince iğne aspirasyon biyopsisi (TİİAB) gerekliliği değerlendirilir. İhtiyaç halinde diğer görüntüleme tekniklerinden (Elastosonografi, Bilgisayarlı Tomografi, Magnetik Rezonans, Radyonüklid görüntüleme) faydalanılabilir. Klinik, radyolojik ve TİİAB sonucu birlikte değerlendirilerek nodülün tedavisine ya da izlenmesine karar verilir.

References

  • Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: The Whickham survey. Clin Endocrinol (Oxf). 1977;7:481-493.
  • Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004;351:1764-1771.
  • Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab. 1955;15:1270-1280.
  • Gharib H, Papini E. Thyroid nodules: Clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am. 2007;36:707-735.
  • Krohn K, Führer D, Bayer Y, Eszlinger M, Brauer V, Neumann S, et al. Molecular pathogenesis of euthyroid and toxic multinodular goiter. Endocr Rev. 2005;26(4):504-24.
  • Van Sande J, Parma J, Tonacchera M, Swillens S, Dumont J, Vassart G. Somatic and germline mutations of the TSH receptor gene in thyroid diseases. J Clin Endocrinol Metab. 1995;80(9):2577-85.
  • Salvi M, Fukazawa H, Bernard N, Hiromatsu Y, How J, Wall JR. Role of auto antibodies in the pathogenesis and association of endocrine autoimmune disorders. Endocr Rev. 1988 Nov;9(4):450-66.
  • Brauer VF, Below H, Kramer A, Führer D, Paschke R. The role of thiocyanate in the etiology of goiter in an industrial metropolitan area. Eur J Endocrinol. 2006;154(2):229-35.
  • Knudsen N, Laurberg P, Perrild H, Bülow I, Ovesen L, Jørgensen T. Risk factors for goiter and thyroid nodules. Thyroid. 2002;12(10):879-88.
  • Punales MK, da Rocha AP, Meotti C, Gross JL, Maia AL. Clinical and oncological features of children and young adults with multiple endocrine neoplasia type 2A.Thyroid. 2008;18:1261-1268.
  • Rosenbaum MA, McHenry CR. Contemporary management of papillary carcinoma of the thyroid gland. Expert Rev Anticancer Ther. 2009;9:317-329.
  • Corrias A, Einaudi S, Chiorboli E, Weber G, Crinò A, Andreo M, et al. Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: Comparison with conventional clinical, laboratory, and imaging approaches. J Clin Endocrinol Metab. 2001;86:4644-4648.
  • Gough J, Scott-Coombes D, Fausto Palazzo F. Thyroid incidentaloma: An evidence-based assessment of management strategy. World J Surg. 2008;32:1264-1268.
  • Christensen SB, Bondeson L, Ericsson UB, Lindholm K. Prediction of malignancy in the solitary thyroid nodule by physical examination, thyroid scan, fine-needle biopsy and serum thyroglobulin: A prospective study of 100 surgically treated patients. Acta Chir Scand. 1984;150:433-439.
  • Tan GH, Gharib H, Reading CC. Solitary thyroid nodule: Comparison between palpation and ultrasonography. Arch Intern Med. 1995;155:2418-2423.
  • Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, et al; Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines: Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13:3-126.
  • Date J, Feldt-Rasmussen U, Blichert-Toft M, Hegedus L, Graversen HP. Long term observation of serum thyroglobulin after resection of nontoxic goiter and relation to ultrasonographically demonstrated relapse. World J Surg.1996;20:351-356.
  • Ross DS. Laboratory assessment of thyroid dysfunction. In: Rose BD, ed. Up To Date. Wellesley, MA: Up To Date, 2005.
  • Elisei R, Bottici V, Luchetti F, Di Coscio G, Romei C, Grasso L, et al. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: Experience in 10,864 patients with nodular thyroid disorders. J Clin Endocrinol Metab. 2004;89:163-168.
  • Solbiati L, Osti V, Cova L, Tonolini M. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol. 2001;11:2411-2424.
  • Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: Predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941-1946.
  • Rago T, Santini F, Scutari M, Pinchera A, Vitti P. Elastography: New developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab. 2007;92:2917-2922.
  • Meller J, Becker W. The continuing importance of thyroid scintigraphy in the era of high-resolution ultrasound. Eur J Nucl Med Mol Imaging. 2002;29:S425-S438.
  • La Rosa GL, Belfiore A, Giuffrida D, Sicurella C, Ippolito O, Russo G, et al. Evaluation of the fine needle aspiration biopsy in the preoperative selection of cold thyroid nodules. Cancer. 1991;67:2137-2141.
  • Tollin SR, Fallon EF, Mikhail M, Goldstein H, Yung E. The utility of thyroid nuclear imaging and other studies in the detection and treatment of underlying thyroid abnormalities in patients with endogenous subclinical thyrotoxicosis. Clin Nucl Med. 2000;25:341-347.
  • Meier DA, Kaplan MM. Radioiodine uptake and thyroid scintiscanning. Endocrinol Metab Clin North Am.2001;30:291-313.
  • Shetty SK, Maher MM, Hahn PF, Halpern EF, Aquino SL. Significance of incidental thyroid lesions detected on CT: Correlation among CT, sonography, and pathology. AJR Am J Roentgenol. 2006 ;187:1349-1356.
  • Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol. 2008;29:563-568.
  • Finkelstein SE, Grigsby PW, Siegel BA. Combined[18F] Fluorodeoxy glucose positron emission tomography and computed tomography (FDG-PET/CT) for detection of recurrent, 131I-negative thyroid cancer. Ann Surg Oncol. 2008;15(1):286-92.
  • Shammas A, Degirmenci B, Mountz JM, McCook BM, Branstetter B, Bencherif B, et. al. 18F-FDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer. J Nucl Med. 2007;48(2):221-6.
  • Kang KW, Kim SK, Kang HS, Lee ES, Sim JS, Lee IG, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxy glucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab. 2003;88(9):4100- 4.
  • Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH et al; Thyroid Study Group, Korean Society of Neuro- and Head and Neck Radiology. Benign and malignant thyroid nodules: US differentiation: Multicenter retrospective study. Radiology.2008;247:762-770.
  • Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas: Prevalence by palpation and ultrasonography. Arch Intern Med. 1994;154:1838-1840.
  • Baloch ZW, Li Volsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36(6):425.
  • Raj MD, Grodski S, Woodruff S, Yeung M, Paul E, Serpell JW. Diagnostic lobectomy is not routinely required to exclude malignancy in thyroid nodules greater than four centimetres.ANZ J Surg. 2012;82(1-2):73-7.
  • Papini E, Bizzarri G, Pacella CM. Percutaneous laser ablation of benign and malignant thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2008;15:434-439.
  • De May RM. Thyroid. In: The Art and Science of Cytopathology. Vol II: Aspiration Cytology. Chicago, IL:ASCP Press, 1996: 703-778.
  • Osamura RY, Hunt JL. Current practices in performing frozen sections for thyroid and parathyroid pathology. Virchows Arch. 2008;453(5):433-40.
  • Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2010 May-Jun;16Suppl 1:1-43.
  • Cooper DS, Doherty GM, Haugen BR, Hauger BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009;19(11):1167.
  • La Rosa GL, Ippolito AM, Lupo L, Cercabene G, Santonocito MG, Vigneri R, et al. Cold thyroid nodule reduction with L-thyroxine can be predicted by initial nodule volume and cytological characteristics. J Clin Endocrinol Metab. 1996;81:4385-4387.
  • Papini E, Petrucci L, Guglielmi R, Panunzi C, Rinaldi R, Bacci V, et al. Long-term changes in nodular goiter: a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules. J Clin Endocrinol Metab. 1998;83:780-783.
  • Moalem J, Suh I, Duh QY. Treatment and prevention of recurrence of multinodular goiter: an evidence-based review of the literature. World J Surg. 2008;32:1301-1312.
  • Verde G, Papini E, Pacella CM, Gallotti C, Delpiano S, Strada S, et al. Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules. Clin Endocrinol (Oxf). 1994;41:719-724.
  • Guglielmi R, Pacella CM, Bianchini A, Bizzarri G, Rinaldi R, Graziano FM, et al. Percutaneous ethanol injection treatment in benign thyroid lesions: role and efficacy. Thyroid. 2004;14:125-131.
  • Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009;19:219-225.
  • Dossing H, Bennedbaek FN, Hegedus L. Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules: One versus three treatments. Thyroid. 2006;16:763-768.
  • Hegedus L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: Current status and future perspectives. Endocr Rev. 2003;24:102-132.
  • Fast S, Nielsen VE, Bonnema SJ, Hegedus L. Time to reconsider nonsurgical therapy of benign non-toxic multinodular goitre: focus on recombinant human TSH augmented radioiodine therapy. Eur J Endocrinol. 2009;160:517-528.
  • Bonnema SJ, Bertelsen H, Mortensen J, Andersen PB, Knudsen DU, Bastholt L, et al. The feasibility of high dose iodine 131 treatment as an alternative to surgery in patients with a very large goiter: Effect on thyroid function and size and pulmonary function. J Clin Endocrinol Metab. 1999;84:3636-3641.
Year 2016, Volume: 7 Issue: 27, 0 - 0, 30.08.2016
https://doi.org/10.17944/mkutfd.42258

Abstract

References

  • Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: The Whickham survey. Clin Endocrinol (Oxf). 1977;7:481-493.
  • Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004;351:1764-1771.
  • Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab. 1955;15:1270-1280.
  • Gharib H, Papini E. Thyroid nodules: Clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am. 2007;36:707-735.
  • Krohn K, Führer D, Bayer Y, Eszlinger M, Brauer V, Neumann S, et al. Molecular pathogenesis of euthyroid and toxic multinodular goiter. Endocr Rev. 2005;26(4):504-24.
  • Van Sande J, Parma J, Tonacchera M, Swillens S, Dumont J, Vassart G. Somatic and germline mutations of the TSH receptor gene in thyroid diseases. J Clin Endocrinol Metab. 1995;80(9):2577-85.
  • Salvi M, Fukazawa H, Bernard N, Hiromatsu Y, How J, Wall JR. Role of auto antibodies in the pathogenesis and association of endocrine autoimmune disorders. Endocr Rev. 1988 Nov;9(4):450-66.
  • Brauer VF, Below H, Kramer A, Führer D, Paschke R. The role of thiocyanate in the etiology of goiter in an industrial metropolitan area. Eur J Endocrinol. 2006;154(2):229-35.
  • Knudsen N, Laurberg P, Perrild H, Bülow I, Ovesen L, Jørgensen T. Risk factors for goiter and thyroid nodules. Thyroid. 2002;12(10):879-88.
  • Punales MK, da Rocha AP, Meotti C, Gross JL, Maia AL. Clinical and oncological features of children and young adults with multiple endocrine neoplasia type 2A.Thyroid. 2008;18:1261-1268.
  • Rosenbaum MA, McHenry CR. Contemporary management of papillary carcinoma of the thyroid gland. Expert Rev Anticancer Ther. 2009;9:317-329.
  • Corrias A, Einaudi S, Chiorboli E, Weber G, Crinò A, Andreo M, et al. Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: Comparison with conventional clinical, laboratory, and imaging approaches. J Clin Endocrinol Metab. 2001;86:4644-4648.
  • Gough J, Scott-Coombes D, Fausto Palazzo F. Thyroid incidentaloma: An evidence-based assessment of management strategy. World J Surg. 2008;32:1264-1268.
  • Christensen SB, Bondeson L, Ericsson UB, Lindholm K. Prediction of malignancy in the solitary thyroid nodule by physical examination, thyroid scan, fine-needle biopsy and serum thyroglobulin: A prospective study of 100 surgically treated patients. Acta Chir Scand. 1984;150:433-439.
  • Tan GH, Gharib H, Reading CC. Solitary thyroid nodule: Comparison between palpation and ultrasonography. Arch Intern Med. 1995;155:2418-2423.
  • Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, et al; Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines: Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13:3-126.
  • Date J, Feldt-Rasmussen U, Blichert-Toft M, Hegedus L, Graversen HP. Long term observation of serum thyroglobulin after resection of nontoxic goiter and relation to ultrasonographically demonstrated relapse. World J Surg.1996;20:351-356.
  • Ross DS. Laboratory assessment of thyroid dysfunction. In: Rose BD, ed. Up To Date. Wellesley, MA: Up To Date, 2005.
  • Elisei R, Bottici V, Luchetti F, Di Coscio G, Romei C, Grasso L, et al. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: Experience in 10,864 patients with nodular thyroid disorders. J Clin Endocrinol Metab. 2004;89:163-168.
  • Solbiati L, Osti V, Cova L, Tonolini M. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol. 2001;11:2411-2424.
  • Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: Predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941-1946.
  • Rago T, Santini F, Scutari M, Pinchera A, Vitti P. Elastography: New developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab. 2007;92:2917-2922.
  • Meller J, Becker W. The continuing importance of thyroid scintigraphy in the era of high-resolution ultrasound. Eur J Nucl Med Mol Imaging. 2002;29:S425-S438.
  • La Rosa GL, Belfiore A, Giuffrida D, Sicurella C, Ippolito O, Russo G, et al. Evaluation of the fine needle aspiration biopsy in the preoperative selection of cold thyroid nodules. Cancer. 1991;67:2137-2141.
  • Tollin SR, Fallon EF, Mikhail M, Goldstein H, Yung E. The utility of thyroid nuclear imaging and other studies in the detection and treatment of underlying thyroid abnormalities in patients with endogenous subclinical thyrotoxicosis. Clin Nucl Med. 2000;25:341-347.
  • Meier DA, Kaplan MM. Radioiodine uptake and thyroid scintiscanning. Endocrinol Metab Clin North Am.2001;30:291-313.
  • Shetty SK, Maher MM, Hahn PF, Halpern EF, Aquino SL. Significance of incidental thyroid lesions detected on CT: Correlation among CT, sonography, and pathology. AJR Am J Roentgenol. 2006 ;187:1349-1356.
  • Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol. 2008;29:563-568.
  • Finkelstein SE, Grigsby PW, Siegel BA. Combined[18F] Fluorodeoxy glucose positron emission tomography and computed tomography (FDG-PET/CT) for detection of recurrent, 131I-negative thyroid cancer. Ann Surg Oncol. 2008;15(1):286-92.
  • Shammas A, Degirmenci B, Mountz JM, McCook BM, Branstetter B, Bencherif B, et. al. 18F-FDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer. J Nucl Med. 2007;48(2):221-6.
  • Kang KW, Kim SK, Kang HS, Lee ES, Sim JS, Lee IG, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxy glucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab. 2003;88(9):4100- 4.
  • Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH et al; Thyroid Study Group, Korean Society of Neuro- and Head and Neck Radiology. Benign and malignant thyroid nodules: US differentiation: Multicenter retrospective study. Radiology.2008;247:762-770.
  • Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas: Prevalence by palpation and ultrasonography. Arch Intern Med. 1994;154:1838-1840.
  • Baloch ZW, Li Volsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36(6):425.
  • Raj MD, Grodski S, Woodruff S, Yeung M, Paul E, Serpell JW. Diagnostic lobectomy is not routinely required to exclude malignancy in thyroid nodules greater than four centimetres.ANZ J Surg. 2012;82(1-2):73-7.
  • Papini E, Bizzarri G, Pacella CM. Percutaneous laser ablation of benign and malignant thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2008;15:434-439.
  • De May RM. Thyroid. In: The Art and Science of Cytopathology. Vol II: Aspiration Cytology. Chicago, IL:ASCP Press, 1996: 703-778.
  • Osamura RY, Hunt JL. Current practices in performing frozen sections for thyroid and parathyroid pathology. Virchows Arch. 2008;453(5):433-40.
  • Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2010 May-Jun;16Suppl 1:1-43.
  • Cooper DS, Doherty GM, Haugen BR, Hauger BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009;19(11):1167.
  • La Rosa GL, Ippolito AM, Lupo L, Cercabene G, Santonocito MG, Vigneri R, et al. Cold thyroid nodule reduction with L-thyroxine can be predicted by initial nodule volume and cytological characteristics. J Clin Endocrinol Metab. 1996;81:4385-4387.
  • Papini E, Petrucci L, Guglielmi R, Panunzi C, Rinaldi R, Bacci V, et al. Long-term changes in nodular goiter: a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules. J Clin Endocrinol Metab. 1998;83:780-783.
  • Moalem J, Suh I, Duh QY. Treatment and prevention of recurrence of multinodular goiter: an evidence-based review of the literature. World J Surg. 2008;32:1301-1312.
  • Verde G, Papini E, Pacella CM, Gallotti C, Delpiano S, Strada S, et al. Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules. Clin Endocrinol (Oxf). 1994;41:719-724.
  • Guglielmi R, Pacella CM, Bianchini A, Bizzarri G, Rinaldi R, Graziano FM, et al. Percutaneous ethanol injection treatment in benign thyroid lesions: role and efficacy. Thyroid. 2004;14:125-131.
  • Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009;19:219-225.
  • Dossing H, Bennedbaek FN, Hegedus L. Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules: One versus three treatments. Thyroid. 2006;16:763-768.
  • Hegedus L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: Current status and future perspectives. Endocr Rev. 2003;24:102-132.
  • Fast S, Nielsen VE, Bonnema SJ, Hegedus L. Time to reconsider nonsurgical therapy of benign non-toxic multinodular goitre: focus on recombinant human TSH augmented radioiodine therapy. Eur J Endocrinol. 2009;160:517-528.
  • Bonnema SJ, Bertelsen H, Mortensen J, Andersen PB, Knudsen DU, Bastholt L, et al. The feasibility of high dose iodine 131 treatment as an alternative to surgery in patients with a very large goiter: Effect on thyroid function and size and pulmonary function. J Clin Endocrinol Metab. 1999;84:3636-3641.
There are 50 citations in total.

Details

Journal Section Review
Authors

Müge Özsan

İhsan Üstün This is me

Cumali Gökçe This is me

Publication Date August 30, 2016
Submission Date January 14, 2016
Published in Issue Year 2016 Volume: 7 Issue: 27

Cite

Vancouver Özsan M, Üstün İ, Gökçe C. Tiroid nodülleri. mkutfd. 2016;7(27).