Thyroid Nodule Inspection as Consideration for Surgery

. Yuliana(1*),

(1) Udayana University
(*) Corresponding Author


Thyroid gland is essential in our body metabolism. Sometimes there are nodules on it, whether on palpation or unexpected finding from an ultrasound test. Based on thyroid function importance in metabolism, then not all thyroid nodule needs to be operated. This article aims to know thyroid nodule test for operation consideration. Total thyroidectomy patients need hormonal thyroid replacement in life. Voice hoarseness and calcium imbalance metabolism often occur post-thyroidectomy. Therefore, operation indication should be well determined by considering risks for every patient. We found that only aggressively grown nodule and cancer need to be operated as soon as possible. Otherwise, it should be observed routinely every 6 to 12 months.


Thyroid nodule, surgery, size

Full Text:



Bomeli SR, LeBeau SO, Ferris RL. (2010). Evaluation of a Thyroid Nodule. Otolaryngol Clin North Am 43(2):229-238. DOI:10.1016/j.otc.2010.01.002.

Bourret JA, (2015). Predictive Models and Technology Present Opportunities to Support Early Diagnosis, Treatment, and Adherence to Guidelines. American Health & Drug Benefit 8(1):39-40. Available online:

Brose, M. S., Nutting, C. M., Jarzab, B., Elisei, R., Siena, S., Bastholt, L., ... & Sherman, S. I. (2014). Sorafenib in radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer: a randomised, double-blind, phase 3 trial. The Lancet, 384(9940), 319-328. DOI: 10.1016/S0140-6736(14)60421-9.

Cabanillas, M. E., Waguespack, S. G., Bronstein, Y., Williams, M. D., Feng, L., Hernandez, M., ... & Busaidy, N. L. (2010). Treatment with tyrosine kinase inhibitors for patients with differentiated thyroid cancer: the MD Anderson experience. The Journal of Clinical Endocrinology & Metabolism, 95(6), 2588-2595. DOI: 10.1210/jc.2009-1923.

Christou N, Mathonnet M. (2013). Complications after total thyroidectomy. J Visc Surg 150:249-256. DOI: 10.1016/j.jviscsurg.2013.04.003.

Cibas ES, Ali SZ. (2009). The Bethesda System for Reporting Thyroid Cytopathology. Thyroid 19:1159–1165. DOI: 10.1089/thy.2009.0274.

Cooper, D. S., Doherty, G. M., Haugen, B. R., Kloos, R. T., Lee, S. L.,

Mandel, S. J., ... & Sherman, S. (2010). Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer (vol 20, pg 674, 2010). Thyroid, 20(8), 942-942. DOI: 10.1089/thy.2009.0110.

Corso, C., Gomez, X., Sanabria, A., Vega, V., Dominguez, L. C., & Osorio, C. (2014). Total thyroidectomy versus hemithyroidectomy for patients with follicular neoplasm. A cost-utility analysis. International Journal of Surgery, 12(8), 837-842. DOI: 10.1016/j.ijsu.2014.07.005.

Davies L, Welch HG. (2014). Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 40:317–322. DOI: 10.1001/jamaoto.2014.1.

Elisei R, Schlumberger MJ, Muller SP, et al. (2013). Cabozantinib in progressive medullary thyroid cancer. J Clin Oncol 31:3639-3646. DOI: 10.1200/JCO.2012.48.4659.

Fitzgerald PA. (2013). Thyroid cancer. In: Papadakis MA, McPhee SJ, eds. Current Medical Diagnosis & Treatment 2013. 52nd ed. US: McGraw-Hill Companies. P.1126-1134.

Frieda IP. (2018). Jangan Malas! Yuk Deteksi Dini Kanker Tiroid dengan PERLAHAN. Diunduh dari: www. -kanker-tiroid-dengan-perlahan. Diakses tanggal 22 November 2018.

Goldfarb M, Gondek S, Solorzano C, Lew JI. (2011). Surgeon-performed ultrasound can predict benignity in thyroid nodules. Surgery 150:436–441. DOI: 10.1016/j.surg.2011.07.002.

Hambleton, C., & Kandil, E. (2013). Appropriate and accurate diagnosis of thyroid nodules: a review of thyroid fine-needle aspiration. International journal of clinical and experimental medicine, 6(6), 413. Available online:


Haugen Bryan, R., AlexanderErik, K., BibleKeith, C., DohertyGerard, M., MandelSusan, J., NikiforovYuri, E., ... & Ann, S. (2016). 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 26(1):101-110. DOI: 10.1089/THY.2015.0020.

Iyer, N. G., Morris, L. G., Tuttle, R. M., Shaha, A. R., & Ganly, I. (2011). Rising incidence of second cancers in patients with low‐risk (T1N0) thyroid cancer who receive radioactive iodine therapy. Cancer, 117(19), 4439-4446. DOI: 10.1002/cncr.26070.

Kamran SC, et al. (2013). Thyroid Nodule Size and Prediction of Cancer. J Clin Endocrimol Metab 98(2):564-570. DOI:10.1210/JC.2012-2968.

Karadeniz Cakmak G, Emre AU, Tascilar O, Gultekin FA, Ozdamar SO,

Comert M. (2013). Diagnostic adequacy of surgeon-performed ultrasound-guided fine needle aspiration biopsy of thyroid nodules. J Surg Oncol. 107:206–10. DOI: 10.1002/jso.23212.

Khavanin, N., Mlodinow, A., Kim, J. Y., Ver Halen, J. P., & Samant, S. (2014). Predictors of 30-day readmission after outpatient thyroidectomy: an analysis of the 2011 NSQIP data set. American journal of otolaryngology, 35(3), 332-339. DOI: 10.1016/j.amjoto.2014.01.011.

Knox MA. (2013). Thyroid nodules. Am Fam Physician 88:193-196. Available online:

Lew JI, Snyder RA, Sanchez YM, Solorzano CC. (2011). Fine needle aspiration of the thyroid: correlation with final histopathology in a surgical series of 797 patients. J Am Coll Surg 213:188–194. DOI:10.1016/j.jamcollsurg.2011.04.029.

Lucchini, R., Monacelli, M., Santoprete, S., Triola, R., Conti, C., Pecoriello, R., ... & Avenia, S. (2013). Differentiated thyroid tumors: surgical indications. Il Giornale di chirurgia, 34(5-6), 153. Available online: ?term=Lucchini+R%2C+Monacelli+M%2C+Santoprete+S%2C+et+al.+2013.+Differentiated+thyroid+tumors%3A+surgical

Luster, M., Clarke, S. E., Dietlein, M., Lassmann, M., Lind, P., Oyen, W. J. G., ... & Bombardieri, E. (2008). Guidelines for radioiodine therapy of differentiated thyroid cancer. European journal of nuclear medicine and molecular imaging, 35(10), 1941. DOI: 10.1007/s00259-008-0883-1.

Mallick, U., Harmer, C., Yap, B., Wadsley, J., Clarke, S., Moss, L., ... &

Smellie, J. (2012). Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer. New England Journal of Medicine, 366(18), 1674-1685. DOI: 10.1056/NEJMoa1109589.

Mazzaferri EL, Sipos J. (2008). Should all patients with subcentimeter thyroid nodules undergo fine-needle aspiration biopsy and preoperative neck ultrasound to define the extent of tumor invasion? Thyroid18:597–602. DOI: 10.1089/thy.2008.0100.

Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A, Plodkowski RA. (2015). Diagnosis and Treatment of Patients with Thyroid Cancer. American Health & Drug Benefit 8(1):30-38. Available online:

Nguyen T, Misra S. (2015). Undifferentiated Anaplastic Sarcomatoid Carcinoma of the Thyroid: Is Surgical Resection Worth it? – A Case Report and Review of Literature. Endocrinol Metab Synd 4: 179. DOI:10.4172/2161- 1017.1000179

Nikiforov YE, Yip L, Nikiforova MN. (2013). New strategies in diagnosing cancer in thyroid nodules: impact of molecular markers. Clin Cancer Res 19:2283-2288. DOI: 10.1158/1078-0432.CCR-12-1253.

Nixon IJ, Ganly I, Shah JP. (2013). Thyroid cancer: surgery for the primary tumor. Oral Oncol. 49:654-658. DOI: 10.1016/j.oraloncology.2013.03.439.

Pemayun TGD. (2016). Current Diagnosis and Management of Thyroid Nodules. Acta Med Indones 48(3):247-257. Available online: https://pdfs. /76c5/ f9d30c46bef3c228cf8ce1cd5b0d0d3f97d3.pdf

Pinchot SN, Al-Wagih H, Schaefer S, Sippel R, Chen H. (2009). Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg. 144:649–655. DOI: : 10.1001/archsurg.2009.116.

Parura Y, Pontoh V, Merung M. (2016). Pola kanker tiroid periode Juli 2013- Juni 2016 di RSUP Prof.Dr.R.D Kandou Manado. Jurnal e-Clinic 4(2):1-6.

Porterfield JR, Grant CS, Dean DS, Thompson GB, Farley DR, Richards ML, Reading CC, Charboneau JW, Vollrath BK, Sebo TJ. (2008). Reliability of benign fine needle aspiration cytology of large thyroid nodules. Surgery 144:963–968. DOI: 10.1016/j.surg.2008.09.006.

Robitschek J, Straub M, Wirtz E, Klem C, Sniezek J. (2010). Diagnostic efficacy of surgeon-performed ultrasound-guided fine needle aspiration: a randomized controlled trial. Otolaryngol Head Neck Surg. 142:306–309. DOI: 10.1016/j.otohns.2009.11.011.

Roy R, Kouniavsky G, Venkat R, Felger EA, Shiue Z, Schneider E, Zeiger MA. (2012). The role of preoperative neck ultrasounds to assess lymph nodes in patients with suspicious or indeterminate thyroid nodules. J Surg Oncol. 105:601–605. DOI: 10.1002/jso.22115.

Rudolph N, Dominguez C, Beaulieu A, et al. (2014). The morbidity of reoperative surgery for recurrent benign nodular goitre: impact of previous unilateral thyroid lobectomy versus subtotal thyroidectomy. J Thyroid Res p.31-8. DOI: 10.1155/2014/231857.

Schlumberger, M., Catargi, B., Borget, I., Deandreis, D., Zerdoud, S., Bridji, B., ... & Vera, P. (2012). Strategies of radioiodine ablation in patients with low-risk thyroid cancer. New England Journal of Medicine, 366(18), 1663-1673. DOI: 10.1056/NEJMoa1108586.

Schulte KM. (2009). The Assessment of Thyroid Nodules. In: Hubbard J, Inabnet W, Lo CY. Endocrine Surgery 1:17-28. DOI: 10.1007/978-1-84628-881-4_2.

Seiberling KA, Dutra JC, Gunn J. (2008). Ultrasound-guided fine needle aspiration biopsy of thyroid nodules performed in the office. Laryngoscope 118:228–231. Available online:

Shore S, Waghorn AJW. (2011). Thyroidectomy. Surgery (Oxf) 29:446-450. DOI: https://doi. org/10.1016/j.mpsur.2011.06.014

Singer, Susanne & Lincke, Thomas & Gamper, Eva & Bhaskaran, Krishnan & Schreiber, Stefan & Hinz, Andreas & Schulte, Thomas. (2011). Quality of Life in Patients with Thyroid Cancer Compared with the General Population. Thyroid : official journal of the American

Thyroid Association 22(2):117-24. DOI 10.1089/thy.2011.0139.

Sipos JA, Mazzaferri EL. (2010). Thyroid cancer epidemiology and prognostic variables. Clin Oncol (R Coll Radiol) 22: 395–404. DOI: 10.1016/j.clon.2010.05.004.

Terris, D. J., Snyder, S., Carneiro-Pla, D., Inabnet III, W. B., Kandil, E., Orloff, L., ... & Yeh for the American Thyroid Association Surgical Affairs Committee Writing Task Force, M. W. (2013). American Thyroid Association statement on outpatient thyroidectomy. Thyroid, 23(10), 1193-1202. DOI: 10.1089/thy.2013.0049.

Ukrainski MB, Pribitkin EA, Miller JL. (2016). Increasing Incidence of Thyroid Nodules and Thyroid Cancer: Does Increased Detection of a Subclinical Reservoir Justify the Associated Anxiety and Treatment? Clinical Therapeutics 38(4): 976-985. DOI:

Vaisman F, Shaha A, Fish S, Tuttle RM. (2011). Initial therapy with either thyroid lobectomy or total thyroidectomy without radioactive iodine remnant ablation is associated with very low rates of structural disease recurrence in properly selected patients with differentiated thyroid cancer. Clin Endocrinol (Oxf) 75:112-119. DOI: 10.1111/j.1365-2265.2011.04002.x.

Valachis A, Nearchou A. (2013). High versus low radioiodine activity in patients with differentiated thyroid cancer: a meta-analysis. Acta Oncol 52:1055-1061. Available online:

Wang CC, Friedman L, Kennedy GC, Wang H, Kebebew E, Steward DL, Zeiger MA, Westra WH, Wang Y, Khanafshar E, Fellegara G, Rosai J,

Livolsi V, Lanman RB. (2011). A large multicenter correlation study of thyroid nodule cytopathology and histopathology. Thyroid. 21:243–251. DOI: 10.1089/thy.2010.0243.

Wartofsky L, Van Nostrand D. (2012). Radioiodine treatment of well-differentiated thyroid cancer. Endocrine 42:506-513. Available online: pmc/articles/PMC4162434/

Weir, H. K., Thompson, T. D., Soman, A., Møller, B., & Leadbetter, S. (2015). The past, present, and future of cancer incidence in the United States: 1975 through 2020. Cancer, 121(11), 1827-1837. Available online: doi/abs/10.1002/cncr.29258

Wells Jr, S. A., Robinson, B. G., Gagel, R. F., Dralle, H., Fagin, J. A., Santoro, M., ... & Read, J. (2012). Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. Journal of clinical oncology, 30(2), 134. Available online:

Wiwit AF, Selvialiany, Welly Z. (2016). Distribusi Keganasan Organ Tiroid Berdasarkan Pemeriksaan Histopatologi di Kota Pekanbaru. JIK 10(2):67-70. Available online:

Yeung SCJ, Habra MA. (2012). Thyroid: Anaplastic (undifferentiated) carcinoma. Atlas Genet Cytogenet Oncol Haematol 16:935-939. Available online: ID5069.pdf

Yoon JH, Kwak JY, Moon HJ, Kim MJ, Kim EK. (2011). The diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy and the sonographic differences between benign and malignant thyroid nodules 3 cm or larger. Thyroid 21:993–1000. DOI: 10.1089/thy.2010.0458.

DOI: 10.24235/sc.educatia.v7i2.2499

Article Metrics

Abstract view : 276 times
PDF - 112 times


  • There are currently no refbacks.

Scientiae Educatia indexed by:

This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. 

Creative Commons License
This work is licensed under a 
Creative Commons Attribution 4.0 International License.

Stat Counter (Link)