Main Article Content
In modern clinical practice, thyroid incidentaloma is an unpalpated node in the thyroid gland, which is detected accidentally by technical means of imaging when examining a patient for other, non-thyroid diseases. Its dimensions are limited to 10 mm, the limit above which it can already be palpated by a qualified professional. In the author’s view, such a definition narrows the concept of incidentaloma, primarily from a nosological point of view. Under the definition of the node can be micro- or macrofollicular nodular goiter, tumor, benign (adenoma) or malignant (carcinoma), the focus of thyroiditis, cyst, inflammatory focus (infiltrate, abscess), calcifications. When enumerating the methods of detection by incidental, the palpation method is excluded and the nodes in the thyroid gland detected with its help are not only up to 10 mm in size but also larger, which should also be called incidental. The same can be said about the nodes that are accidentally found on the neck during operations for diseases of the trachea, cervical esophagus, salivary glands. Speaking of incidentalomas, which are detected at autopsy, it should be noted that some of them are larger than 10 mm. All these positions do not fit into the definition of thyroid incidentaloma only as an unpalpated node in the thyroid gland up to 10 mm, which is determined by instrumental imaging methods. Therefore, the concept of thyroid incidentaloma is broader and more capacious than formulated by its modern definition. Incidental thyroid disease should be considered any additional formation in it, regardless of its size, detected by any non-target method of research. Unpalpated and, as a rule, clinically “dumb” nodes up to 10 mm, determined by instrumental methods, can be considered as one of the subspecies of the incidentaloma. The frequency of their detection has increased sharply in recent years, some are malignant neoplasms with an unpredictable course, tactical approaches to them have not been finalized.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968 Sep;69(3):537-40. doi: 10.7326/0003-4819-69-3-537.
Frates MC, Benson CB, Charboneau JW, et al; Society of Radiologists in Ultrasound. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2005 Dec;237(3):794-800. doi: 10.1148/radiol.2373050220.
Jiang H, Tian Y, Yan W, et al. The Prevalence of Thyroid Nodules and an Analysis of Related Lifestyle Factors in Beijing Communities. Int J Environ Res Public Health. 2016 Apr 22;13(4):442. doi: 10.3390/ijerph13040442.
Christensen SB, Tibblin S. The reliability of the clinical examination of the thyroid gland. A prospective study of 100 consecutive patients surgically treated for hyperparathyroidism. Ann Chir Gynaecol. 1985;74(4):151-4.
Brander A, Viikinkoski P, Tuuhea J, Voutilainen L, Kivisaari L. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J Clin Ultrasound. 1992 Jan;20(1):37-42. doi: 10.1002/jcu.1870200107.
Ahmed S, Horton KM, Jeffrey RB Jr, Sheth S, Fishman EK. Incidental thyroid nodules on chest CT: Review of the literature and management suggestions. AJR Am J Roentgenol. 2010 Nov;195(5):1066-71. doi: 10.2214/AJR.10.4506.
Brito JP, Gionfriddo MR, Al Nofal A, et al. The accuracy of thyroid nodule ultrasound to predict thyroid cancer: systematic review and meta-analysis. J Clin Endocrinol Metab. 2014 Apr;99(4):1253-63. doi: 10.1210/jc.2013-2928.
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 Nov;187(5):1349-56. doi: 10.2214/AJR.05.0468.
Nguyen XV, Choudhury KR, Eastwood JD, et al. Incidental thyroid nodules on CT: evaluation of 2 risk-categorization methods for work-up of nodules. AJNR Am J Neuroradiol. 2013 Sep;34(9):1812-7. doi: 10.3174/ajnr.A3487.
Yoon DY, Chang SK, Choi CS, et al. The prevalence and significance of incidental thyroid nodules identified on computed tomography. J Comput Assist Tomogr. 2008 Sep-Oct;32(5):810-5. doi: 10.1097/RCT.0b013e318157fd38.
Shie P, Cardarelli R, Sprawls K, Fulda KG, Taur A. Systematic review: prevalence of malignant incidental thyroid nodules identified on fluorine-18 fluorodeoxyglucose positron emission tomography. Nucl Med Commun. 2009 Sep;30(9):742-8. doi: 10.1097/MNM.0b013e32832ee09d.
Chun AR, Jo HM, Lee SH, et al. Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography. Endocrinol Metab (Seoul). 2015 Mar 27;30(1):71-7. doi: 10.3803/EnM.2015.30.1.71.
Uppal A, White MG, Nagar S, et al. Benign and Malignant Thyroid Incidentalomas Are Rare in Routine Clinical Practice: A Review of 97,908 Imaging Studies. Cancer Epidemiol Biomarkers Prev. 2015 Sep;24(9):1327-31. doi: 10.1158/1055-9965.EPI-15-0292.
Drake T, Gravely A, Westanmo A, Billington C. Prevalence of Thyroid Incidentalomas from 1995 to 2016: A Single-Center, Retrospective Cohort Study. J Endocr Soc. 2019 Nov 29;4(1):bvz027. doi: 10.1210/jendso/bvz027.
Hoang JK, Langer JE, Middleton WD, et al. Managing incidental thyroid nodules detected on imaging: white paper of the ACR Incidental Thyroid Findings Committee. J Am Coll Radiol. 2015 Feb;12(2):143-50. doi: 10.1016/j.jacr.2014.09.038.
Moifo B, Moulion Tapouh JR, et al. Ultrasonographic prevalence and characteristics of non-palpable thyroid incidentalomas in a hospital-based population in a sub-Saharan country. BMC Med Imaging. 2017 Mar 4;17(1):21. doi: 10.1186/s12880-017-0194-8.
Rad M, Zakavy S, Layegh H, et al. Incidental thyroid abnormalities on carotid collor Doppler ultrasound frequency and clinical significance. J Med Ultrasound. 2015;23(1):25-28. doi: 10.1016/j.jmu.2014.04.005.
Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002 May;87(5):1941-6. doi: 10.1210/jcem.87.5.8504.
Steele SR, Martin MJ, Mullenix PS, Azarow KS, Andersen CA. The significance of incidental thyroid abnormalities identified during carotid duplex ultrasonography. Arch Surg. 2005 Oct;140(10):981-5. doi: 10.1001/archsurg.140.10.981.
Hoang JK, Raduazo P, Yousem DM, Eastwood JD. What to do with incidental thyroid nodules on imaging? An approach for the radiologist. Semin Ultrasound CT MR. 2012 Apr;33(2):150-7. doi: 10.1053/j.sult.2011.12.004.
Kim TY, Kim WB, Ryu JS, Gong G, Hong SJ, Shong YK. 18F-fluorodeoxyglucose uptake in thyroid from positron emission tomogram (PET) for evaluation in cancer patients: high prevalence of malignancy in thyroid PET incidentaloma. Laryngoscope. 2005 Jun;115(6):1074-8. doi: 10.1097/01.MLG.0000163098.01398.79.
Kim EK, Park CS, Chung WY, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 2002 Mar;178(3):687-91. doi: 10.2214/ajr.178.3.1780687.
Cappelli C, Castellano M, Pirola I, Gandossi E, De Martino E, Cumetti D, Agosti B, Rosei EA. Thyroid nodule shape suggests malignancy. Eur J Endocrinol. 2006 Jul;155(1):27-31. doi: 10.1530/eje.1.02177.
Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009 May;94(5):1748-51. doi: 10.1210/jc.2008-1724.
Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011 Sep;260(3):892-9. doi: 10.1148/radiol.11110206.
Belfiore A, La Rosa GL, La Porta GA, et al. Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med. 1992 Oct;93(4):363-9. doi: 10.1016/0002-9343(92)90164-7.
Song B, Wang H, Chen Y, et al. Magnetic resonance imaging in the prediction of aggressive histological features in papillary thyroid carcinoma. Medicine (Baltimore). 2018 Jun;97(26):e11279. doi: 10.1097/MD.0000000000011279.
Bogsrud TV, Karantanis D, Nathan MA, et al. The value of quantifying 18F-FDG uptake in thyroid nodules found incidentally on whole-body PET-CT. Nucl Med Commun. 2007 May;28(5):373-81. doi: 10.1097/MNM.0b013e3280964eae.
Choi JS, Choi Y, Kim EK, et al. A risk-adapted approach using US features and FNA results in the management of thyroid incidentalomas identified by 18F-FDG PET. Ultraschall Med. 2014 Feb;35(1):51-8. doi: 10.1055/s-0033-1335328.
de Koster EJ, Kist JW, Vriens MR, Borel Rinkes IH, Valk GD, de Keizer B. Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate. Acta Cytol. 2016;60(1):39-45. doi: 10.1159/000444917.
Haugen BR, Alexander EK, Bible KC, et al. 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. Thyroid. 2016 Jan;26(1):1-133. doi: 10.1089/thy.2015.0020.
Rosai J, LiVolsi VA, Sobrinho-Simoes M, Williams ED. Renaming papillary microcarcinoma of the thyroid gland: the Porto proposal. Int J Surg Pathol. 2003 Oct;11(4):249-51. doi: 10.1177/106689690301100401.
Zafon C, Baena JA, Castellví J, Obiols G, Monroy G, Mesa J. Differences in the Form of Presentation between Papillary Microcarcinomas and Papillary Carcinomas of Larger Size. J Thyroid Res. 2010 Dec 14;2011:639156. doi: 10.4061/2011/639156.
Solares CA, Penalonzo MA, Xu M, Orellana E. Occult papillary thyroid carcinoma in postmortem species: prevalence at autopsy. Am J Otolaryngol. 2005 Mar-Apr;26(2):87-90. doi: 10.1016/j.amjoto.2004.08.003.
Furuya-Kanamori L, Bell KJL, Clark J, Glasziou P, Doi SAR. Prevalence of Differentiated Thyroid Cancer in Autopsy Studies Over Six Decades: A Meta-Analysis. J Clin Oncol. 2016 Oct 20;34(30):3672-3679. doi: 10.1200/JCO.2016.67.7419.
Nam-Goong IS, Kim HY, et al. Ultrasonography-guided fine-needle aspiration of thyroid incidentaloma: correlation with pathological findings. Clin Endocrinol (Oxf). 2004 Jan;60(1):21-8. doi: 10.1046/j.1365-2265.2003.01912.x.
Dideban S, Abdollahi A, Meysamie A, Sedghi S, Shahriari M. Thyroid Papillary Microcarcinoma: Etiology, Clinical Manifestations,Diagnosis, Follow-up, Histopathology and Prognosis. Iran J Pathol. 2016 Winter;11(1):1-19.
Barbaro D, Simi U, Meucci G, Lapi P, Orsini P, Pasquini C. Thyroid papillary cancers: microcarcinoma and carcinoma, incidental cancers and non-incidental cancers - are they different diseases? Clin Endocrinol (Oxf). 2005 Nov;63(5):577-81. doi: 10.1111/j.1365-2265.2005.02386.x.
Zevallos JP, Hartman CM, Kramer JR, Sturgis EM, Chiao EY. Increased thyroid cancer incidence corresponds to increased use of thyroid ultrasound and fine-needle aspiration: a study of the Veterans Affairs health care system. Cancer. 2015 Mar 1;121(5):741-6. doi: 10.1002/cncr.29122.
Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid. 2014;24(1):27-34. doi: 10.1089/thy.2013.0367.