Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- nódulo palpável da tireoide
Other diagnostic factors
- extremidades etárias
- história familiar de câncer de tireoide
- rouquidão
- dispneia
- disfagia
- desvio da traqueia
- linfadenopatia cervical
- rápido aumento cervical
Risk factors
- irradiação da cabeça e do pescoço
- sexo feminino
- história familiar de câncer de tireoide
Diagnostic investigations
1st investigations to order
- hormônio estimulante da tireoide (TSH)
- ultrassonografia da tireoide/pescoço
- Aspiração por agulha fina (AAF)
Investigations to consider
- teste molecular das amostras de citologia
- T4 livre
- T3 livre
- laringoscopia
- cintilografia da tireoide com captação de I-123
- punção por agulha grossa (core biopsy)
- tomografia computadorizada (TC) do pescoço
- calcitonina sérica
- teste genético para síndromes familiares
- tireoglobulina sérica
Emerging tests
- ultrassonografia translaríngea
- biópsia do linfonodo sentinela
Treatment algorithm
papilar, folicular ou oncocítico
anaplásico
medular
Contributors
Authors
Rajiv Datta, MD, FACS, FRCS, FICS
Chairman
Department of Surgery
Professor Of Surgery, Icahn School of Medicine at Mount Sinai
Chief
Division of Surgical Oncology
Chief
Division of Head and Neck Surgery
Mount Sinai South Nassau Hospital
Oceanside
NY
Disclosures
RD declares that he has no competing interests.
Peer reviewers
Rosemarie Metzger, MD, MPH, FACS
Associate Professor of Surgery, Endocrine Surgery Division
Banner - University Medical Center
Phoenix
AZ
Disclosures
RM declares that she has no competing interests.
Lindsay Bischoff, MD
Associate Professor
Medical Director Vanderbilt Thyroid Center
Vanderbilt University Medical Center
Nashville
TN
Disclosures
LB declares that she has no competing interests.
F. Fausto Palazzo, MS, FRCS
Consultant Endocrine Surgeon
Hammersmith & Charing Cross Hospitals
Clinical Lead for Endocrine Surgery
Honorary Senior Lecturer
Imperial College
London
UK
Disclosures
FFP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Haugen BR, Alexander EK, Bible KC, et al; American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016 Jan;26(1):1-133.Full text Abstract
Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015 Jun;25(6):567-610.Full text Abstract
Gharib H, Papini E, Garber JR, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules - 2016 update. Endocr Pract. 2016 May;22(5):622-39.Full text Abstract
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: thyroid carcinoma [internet publication].Full text
European Society for Medical Oncology. Clinical practice guidelines - thyroid cancer. 2019 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Nódulo tireoidiano benigno
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