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New Paradigms in the Diagnosis and Management of Thyroid Nodules

Bui, Amy MD*; Mazzaferri, Ernest L. MD, MACP†

doi: 10.1097/01.ten.0000257436.13363.b2
CME Review Article #3

It is estimated that annually 275,000 new thyroid nodules are found by palpation in the United States.1 This number is expected to increase 10-fold with the use of thyroid ultrasonography.2 Thyroid cancer in the United States is the most rapidly rising cause of cancer in women and cancer death in men.3 Delay in diagnosis is an important harbinger of poor outcome, and it is thus important to understand how to distinguish benign from malignant thyroid disease with a high degree of accuracy. Ultrasound-guided fine-needle aspiration biopsy, which has become a widely used tool in the evaluation of thyroid nodules, has greatly enhanced office evaluation of nodules. This review will discuss the genetic alterations in thyroid follicular cells that lead to the formation of malignant nodules, and the current diagnostic and therapeutic approaches to nodular thyroid disease.

*Endocrinology Fellow, Division of Endocrinology and Metabolism, University of Florida, Gainesville, FL; and †Professor of Medicine, Division of Endocrinology and Metabolism, University of Florida, Gainesville, FL.

Lippincott Continuing Medical Education Institute, Inc. has identified and resolved all faculty conflicts of interest regarding this educational activity.

The authors have disclosed that they have no significant relationships with or financial interests in any commercial company that pertains to this educational activity.

Reprints: Dr. Mazzaferri, Division of Endocrinology and Metabolism, University of Florida, 4020 SW 93rd Drive, Gainesville, FL 32608-4653. E-mail:

Chief Editor’s Note: This article is the 3rd of 36 that will be published in 2007 for which a total of up to 36 AMA PRA Category 1 Credits™ can be earned. Instructions for how credits can be earned precede the CME Examination at the back of this issue.

© 2007 Lippincott Williams & Wilkins, Inc.