Risk of neoplasia and malignancy in "dominant" thyroid swellings.

Cusick, E L; Krukowski, Z H; MacIntosh, C A; Matheson, N A · BMJ · 1991

prospective_cohort · Level II

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Abstract

To determine the risk of neoplasia and malignancy in "dominant" thyroid swellings. Prospective analysis during six years. Thyroid clinic serving the Grampian region. 574 consecutive patients presenting with a discrete thyroid swelling, of whom 179 (31%) were classified clinically as having a dominant area of enlargement within a multinodular gland. After clinical and cytological assessment 77 dominant swellings were excised. Of the excised swellings, 45 were non-neoplastic and 32 neoplastic, including 11 malignant lesions. The minimum incidence of neoplasia and malignancy in all 179 dominant swellings was therefore 18% and 6% respectively. Dominant thyroid swellings should be regarded with greater clinical suspicion than has been traditional.

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