Thyroid nodules enlarge with time (I)
(March 2003)
The background of
the study. Thyroid nodules are very common, but little is
known about their natural history. In this study, patients with
several types of thyroid nodules, some of whom were treated with
thyroxine or iodine, were followed for up to 12 years.
How the study was done. There were
95 women and 14 men with a total of 139 benign thyroid nodules that
were >1 cm in diameter. Eighty-one patients had one nodule, and
28 patients had two or more nodules. The volume was ≤10 ml
in 110 nodules (79 percent), and it was >10 ml in 29 (21 percent).
Thyroid scanning revealed that 86 (62 percent) of the nodules were
functioning and 53 (38 percent) were nonfunctioning. Thyroid and
nodule volume was measured by ultrasonography yearly for an average
of 5 years (range, 3 to 12); an increase in volume of ≥30
percent was considered enlargement.
The results of the study. Thyroid
gland volume increased by ≥30 percent in 23 percent of the
patients in three years and 51 percent in five years. Nodule volume
increased by ≥30 percent in 48 percent of the patients in
three years and in 61 percent in five years. The increases in both
thyroid and nodule volume were independent of the volume of the
thyroid or the nodule at base line; age, sex, and thyroid function
at base line; and either thyroxine or iodine treatment.
The conclusions of the study. Benign
thyroid nodules tend to enlarge slowly with time.
The original article. Quadbeck B,
Pruellage J, Roggenbuck U, Hirche H, Janssen OE, Mann K, Hoermann
R. Long-term follow-up of thyroid nodule growth. Exp Clin Endocrinol
Diabetes 2002;110:348-54.
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